Biomedical subjects

J Wehba

Publications and source records attributed to J Wehba.

24 records · Page 2Linked to original sources

PubMedDate not supplied

Small bowel bacterial flora in normal and in children with acute diarrhea.

The aerobic bacteria microflora of the upper small bowel in normal children and in children with acute diarrhea was studied. Forty one children aging between 2 months and 5 years were divided in 3 groups: Group I--13 wellnourished children with no signs of gastrointestinal abnormalities remained intubated for less than 4 hours; Group II--11 wellnourished children that remained intubated for a period of time varying from 4 to 24 hours; Group III--17 children with acute diarrhea. There was a striking difference in the bacterial pattern between children from groups I and II and these findings were attributed to the prolonged time of intubation. In group I the jejunal fluid was sterile in approximately 40% of the children and in the others there was only growth of a GRAM positive flora while in group II the jejunal fluid never presented as a sterile one, and in approximately 73% of the cases there was a growth of a mixed GRAM positive and GRAM negative microflora, mainly due to Enterobacteria. In group III an aerobic microflora different from that one verified in group I was found in 76,4% of the patients. In 47.05% of the cases a bacterial growth equivalent to the fecal flora has been observed, in 5.89% Pseudomonas aeruginosa was located and in 23.52% yeasts were cultured from the jejunal fluid. These data confirm the hypothesis that bacterial and fungi infections are most prevalent in underdeveloped countries. This is probably due to the poor sanitary conditions observed in these countries associated with a high index of environmental contamination.

Acute Disease↗

PubMedDate not supplied

Hereditary hemorrhagic telangiectasia associated to chronic active hepatitis.

Hereditary hemorrhagic telangiectasia or Rendu-Osler-Weber syndrome (ROWS) is an angiodisplasia characterized clinically by the presence of telangiectasias in the skin and mucosas, particularly on the face, conjunctivas, nose, pharynx and rarely on the thorax. Visceral involvement specially hepatic cirrhosis associated with pulmonary arteriovenous fistulae have been described. We describe a 7 10/12 years old girl with the diagnosis of ROWS associated with chronic active hepatitis with positive HBAg that evolved to hepatic cirrhosis. This is the second case of ROWS associated with chronic active hepatitis reported in the literature, being however, the first one described in the childhood.

Biopsy, Needle↗

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

[Serum antigliadin antibodies in the diagnosis and follow-up of celiac disease].

Between July 1985 and June 1990, we prospectively investigated 236 children suspected of having malabsorption syndrome. Each patient had a xylose absorption test and small intestinal biopsy. Blood samples were collected to AGA assay. The aim of the study was to evaluate the use of antigliadin antibodies test, IgG and IgA, in screening celiac disease for intestinal biopsy and in the monitoring of gluten-free diet and challenge in celiac patients. Twenty patients were diagnosed with celiac disease confirmed by three small intestinal biopsies; 12 patients were suspected of having celiac disease, with two biopsies, before and one year after a gluten-free diet; 106 patients had environmental enteropathy; 45 patients had protracted diarrhea and 56 children had failure to thrive with no gastrointestinal symptoms. The AGA test was considered a reliable test in screening for biopsy and in the differential diagnosis between celiac disease and other causes of malabsorption syndrome. The IgG AGA test had high sensitivity (90.4%) and the IgA AGA test had high specificity (92.1%) in screening for celiac disease. In the follow-up of the celiac patients the antibody levels were significantly higher during gluten containing diet than after gluten avoidance being thus a reliable test to evaluate dietary compliance.

Autoantibodies↗

PubMedDate not supplied

[Steatocrit and Sudan III in the study of steatorrhea in children: comparison with the Van de Kamer method].

Steatorrhea was investigated in 50 children, through Van de Kamer test, Sudan III and steatocrit, in order to compare these three methods. Steatocrit showed better correlation with Van de Kamer test, obtaining sensibility and specificity of 91% and 87%, respectible, on stools took before homogenizing the feces collected during 72 hours. In this same situation, Sudan III showed sensibility of 73% and specificity of 69%. As in the Van de Kamer test, steatocrit represents the final expression of all fecal lipids, what does not happen with Sudan III.

Analysis of Variance↗

PubMedDate not supplied

[Dermatoglyphic patterns in celiac disease].

In 1990 a project was performed in Israel in which the authors reported a higher frequency of whorls and a lower frequency of ulnar loops in the dermatoglyphic pattern of children with celiac disease than in children belonging to control group. Based on these findings we carried out a similar study with our local population. Thirty six celiac children, their parents and siblings had their fingerprints analysed and compared to a control group matching for age, sex and race, in order to assess the efficiency of this method for the diagnosis of celiac disease. A statistically significant higher frequency of whorls and arches was found in celiac children than in control group (whorls = 40.6%, arches = 11.7%; whorls = 30.3%, arches = 5.0%, respectively) as well as a strong correlation between the dermatoglyphic pattern of the parents and their celiac children. There was also a statistically higher frequency of whorls > = 4 in celiac children (55.6%) than in controls (30.6%). The conclusion is that the dermatoglyphic pattern analysis can be used as a complementary data. Due to its low sensitivity (55.6%) and specificity (69.4%) considering the presence of four or more whorls, it is not useful as a screening or as a method itself, for the diagnosis of celiac disease.

Celiac Disease↗