[Neonatal and infant jaundice associated with congenital metabolic disorders].
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The necessity is emphasized to perform always a careful anamnesis and a clinical inspection of patients before achieving laboratory examinations (avoiding to demand to a "check up" the diagnosis). This is particularly important in those diseases, like viral hepatitis, which become even more frequent, so that such diagnosis may be supposed basing on unreliable laboratory findings. The possibility is mentioned that different hepato-colangiopathies (Wilson's disease, intolerance to fructose, hepatic congenital fibrosis, hepatic ductal hypoplasia, granulomatous hepatitis, bacterial, micotic and protozoarian cholangitis, liver sufference in onchologic diseases) may simulate viral hepatitis.
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OBJECTIVE: To evaluate in 14 healthy volunteers the gastrointestinal tolerance to an indigestible bulking sweetener containing fructo-oligosaccharides (FOS). DESIGN: In order to mimic their usual pattern of consumption, FOS were ingested throughout the day either occasionally (once a week, first period) or regularly (every day, second period). In the two patterns of consumption, daily sugar doses were increased until diarrhoea and/or a symptom graded 3 (i.e. severe) occurred, or when subjects did not want to ingest more candies. SETTING: Clinical Nutrition Unit, Hôpital Saint-Lazare, Paris. RESULTS: In both periods, the first symptom which occurred was excessive flatus (> 30 g FOS/day): borborygmi and bloating appeared at a higher level (> 40 g/day); lastly, abdominal cramps and diarrhoea occurred at a very much higher level (50 g/day). The volumes of hydrogen excreted in breath in response to the same load of FOS were not different between the two periods. CONCLUSIONS: Chronic consumption of FOS initiated cautiously with subsequent gradual increase did not improve tolerance, nor reduce breath excretion of hydrogen.
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