Luteinizing hormone secretion in men with chronic Chagas' disease.
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Biomedical subjects
Publications and source records attributed to N Iazigi.
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Intestinal permeability tests have been increasingly used in the clinical management of small bowel diseases. Nevertheless, the application of such tests in Brazil is still limited. In this study we report the results of the application of 51Cr-EDTA for assessment of intestinal permeability in 13 healthy volunteers, 10 control patients with miscellaneous disorders, but without evidence of small bowel involvement, 11 patients with well characterized diseases affecting the small bowel, and five patients with inflammatory conditions affecting exclusively the colon. Urinary radioactivity levels in the 24 h following the ingestion of 51Cr-EDTA, expressed as the percentage of the ingested dosis, ranged from 1.99 to 5.93% (median: 3.14%) in healthy volunteers and was not significantly different from the results obtained in control patients (range: 1.48-3.98%; median 3.32%). Based on data from these two control groups, an upper limit of the normal range was set at 5.17% (95% confidence interval). Among patients with diseases of the small bowel, results ranged from 1.58 to 14.85% (median: 8.07%) and were significantly different from those observed in the control groups. Only two out of the 11 patients in this group had abnormal results. In the group of patients with diseases of the colon, results ranged from 3.48 to 5.13% (medium: 4.54%) and were not significantly different from the results obtained in control subjects. All patients in this group had results within the normal range. Data from control subjects and patients with diseases of the small bowel were used for the calculations of sensitivity (81%), specificity (96%), as well as false-positive (4.3%) and false-negative (18.1%) rates. Taken as a whole, the results of the present study indicate that the 51Cr EDTA test of intestinal permeability is accurate and may be useful in the clinical management of small bowel diseases in Brazilian patients.
Persistent diarrhea, a condition highly prevalent in developing countries, causes different morphological and functional alterations of the mucosa of the small intestine, including increased permeability to different test molecules. In the present study we investigate for the first time the intestinal permeability to 51Cr-EDTA of Brazilian children with persistent diarrhea. The test of 51Cr-EDTA absorption was performed in 13 control children and in 14 children with persistent diarrhea by offering 50 microCi of the test substance by the oral route, with later detection of radioactivity excreted in 24-hour urine. There was a statistically significant difference between the control group (median = 1.26; range = 0.20-3.31%) and the group with persistent diarrhea (median = 4.68; range = 1.40-10.29%). Using the minimum and maximum values detected in the control group as the normal reference standard for the test of urinary 51Cr-EDTA absorption, we observed that 61.5% of the patients with persistent diarrhea showed altered results. Among the patients with persistent diarrhea, 51Cr-EDTA excretion was significantly higher in the group fed a protein hydrolysate diet and/or total parenteral nutrition than in the group that did not receive this diet. In four patients with persistent diarrhea, the test was performed after clinical recovery, with a fall in the excretion levels in all cases. On the basis of these data, we may conclude that: 1) in persistent diarrhea there must be alteration of intestinal permeability that might permit an increased entry of local alimentary antigens, with subsequent sensitization and allergic enteropathy, contributing to the perpetuation of the diarrhea, malabsorption and malnutrition cycle; 2) the 51Cr-EDTA test may be useful as an indicator of severity in persistent diarrhea; 3) alteration of intestinal permeability is a secondary phenomenon in persistent diarrhea, with normalization occurring after reconstruction of the intestinal barrier.