Producción Científica UPeU

URI permanente para esta comunidadhttps://cris.upeu.edu.pe/handle/123456789/1

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1991 - 19979

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Fecha de inicio: 1990Fecha de finalización: 1997

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  • Publicacion
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    [Controlled study of the effect of silymarin on alcoholic liver disease].
    (1992-12-01)
    Daniel Bunout
    ;
    Sandra Hirsch
    ;
    Marcus Petermann
    ;
    María Pía de la Maza
    ;
    G Silva
    A controlled trial on the use of Silymarin in patients with alcoholic liver disease was performed. Seventy two patients were admitted to the trial and randomly assigned to an experimental or controls group. Experimentals received 280 mg/day of Silymarin and controls an equal number of placebo tablets. Three patients on placebo and nine on Silymarin were lost from control (p = 0.035), remaining in control 34 patients receiving placebo and 25 patients receiving the drug. Both groups did not differ in their initial laboratory assessment and were followed up for an average of 15 months. Ten patients died during the follow up (5 in placebo and 5 in Silymarin); life table analysis did not show significant differences in mortality. Patients who died had lower serum albumin and prothrombin time and higher total bilirubin, alkaline phosphatases and CCLI on the initial clinical and laboratory assessment. Final laboratory values and their changes in those who survived did not differ between Silymarin and placebo. Twenty two patients on placebo (65%) and 14 on Silymarin (58%) recognized alcohol ingestion or had a positive urine sample analysis for alcohol during follow up. Those who abstained from alcohol had a significant fall in gamma glutamyl transferase during follow up. No other significant differences were observed between these two groups. It is concluded that in this trial, Silymarin did not change the evolution or mortality of alcoholic liver disease.
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    Controlled Trial on Nutrition Supplementation in Outpatients With Symptomatic Alcoholic Cirrhosis
    (1993-03-01)
    Sandra Hirsch
    ;
    Daniel Bunout
    ;
    Pı́a de la Maza
    ;
    H Iturriaga
    ;
    Margarita Petermann
    A controlled trial on nutrition supplementation in ambulatory patients with decompensated alcoholic liver disease was carried out during 1 year. Fifty-one patients were studied; 26 were assigned to an experimental group receiving a daily supplement of 1000 kcal and 34 g of proteins given as a casein-based enteral nutrition product and 25 to a control group receiving one placebo capsule. Patients were examined in a special clinic once a month or more if required. Sixty-eight percent of patients admitted to alcohol ingestion or had alcohol in urine samples on at least one occasion. Dietary recalls showed a significantly higher protein and caloric intake in case patients subjects (p < .0001). Nine patients died during the study, three case patients and six control patients (p = NS). The frequency of hospitalizations was significantly less in the experimental group. This difference was attributed to a reduction in severe infections. Mid-arm circumference, serum albumin concentration, and hand grip strength improved earlier in case patients, although both groups had a significant improvement in these parameters. Bilirubin and aspartate aminotransferase decreased and prothrombin time increased significantly in both groups during the study period, without differences between groups. It is concluded that nutrition support decreases nutrition-associated complications in patients with alcoholic liver disease.
  • Publicacion
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    [Prediction of histological liver damage in asymptomatic alcoholic patients by means of clinical and laboratory data].
    (1993-04-01)
    H Iturriaga
    ;
    Steffen Hirsch
    ;
    Daniel Bunout
    ;
    Miguel Ángel Díaz
    ;
    Matt Kelly
    Looking for a noninvasive method to predict liver histologic alterations in alcoholic patients without clinical signs of liver failure, we studied 187 chronic alcoholics recently abstinent, divided in 2 series. In the model series (n = 94) several clinical variables and results of common laboratory tests were confronted to the findings of liver biopsies. These were classified in 3 groups: 1. Normal liver; 2. Moderate alterations; 3. Marked alterations, including alcoholic hepatitis and cirrhosis. Multivariate methods used were logistic regression analysis and a classification and regression tree (CART). Both methods entered gamma-glutamyltransferase (GGT), aspartate-aminotransferase (AST), weight and age as significant and independent variables. Univariate analysis with GGT and AST at different cutoffs were also performed. To predict the presence of any kind of damage (Groups 2 and 3), CART and AST > 30 IU showed the higher sensitivity, specificity and correct prediction, both in the model and validation series. For prediction of marked liver damage, a score based on logistic regression and GGT > 110 IU had the higher efficiencies. It is concluded that GGT and AST are good markers of alcoholic liver damage and that, using sample cutoffs, histologic diagnosis can be correctly predicted in 80% of recently abstinent asymptomatic alcoholics.
  • Publicacion
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    [Liver cirrhosis and pregnancy].
    (1994-01-01)
    E Roncone
    ;
    R Bianchi
    ;
    R Silva
    ;
    O Valderrama
    ;
    Ricardo Rubio
    A clinical case of a woman 25 year old with Laennec's cirrhosis at 18th, week of gestation was admitted in our hospital. In the 30th week a cesarean section was performed, resulting a healthy infant. The infrequency relationship between pregnancy and cirrhosis is discussed an a review of the literature is presented.
  • Publicacion
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    Protein turnover in abstinent and non-abstinent patients with alcoholic cirrhosis.
    (1995-02-01)
    Sandra Hirsch
    ;
    María Pía de la Maza
    ;
    Marcus Petermann
    ;
    H Iturriaga
    ;
    OBJECTIVE: This study was designed to measure the effect of chronic alcohol intake on leucine turnover in outpatients with stable alcoholic liver cirrhosis. METHODS: Protein turnover rate was measured using L [1-14C] leucine in ten outpatients with proven alcoholic cirrhosis and in five healthy controls. After the performance of the turnover, the patients were divided in two groups depending on the evidence of alcohol ingestion in the previous month. RESULTS: Non-abstinent patients had a significantly higher leucine flux and non-oxidative disposal (73.8 +/- 25.4 and 65.9 +/- 21.6) than abstinent cirrhotic patients (48.9 +/- 9.5 and 43.7 +/- 9.0) and normal controls 37.3 +/- 8.9 and 31.1 +/- 7.6 mumol/m2/min (p < 0.01). Leucine oxidation and serum leucine levels were similar in the three groups. CONCLUSION: Alcohol intake in alcoholic cirrhotic patients has a catabolic effect that could be associated with the nutritional imbalances observed in alcoholic liver disease.
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    [Major histocompatibility system as a risk factor for alcoholic liver disease].
    (1995-06-01)
    Elena Llop
    ;
    Sandra Hirsch
    ;
    de la Maza
    ;
    Daniel Bunout
    ;
    H Iturriaga
    Several associations between alleles of the major histocompatibility system and alcoholic liver disease have been described. However, these are weak and change from one population to another. The aim of this work was to search for a possible genetic risk factor for alcoholic liver disease among Chilean alcoholics. We studied blood groups, serum proteins and HLA antigens in 39 alcoholic cirrhotics, 104 asymptomatic alcoholics and 44 non alcoholic controls. Asymptomatic alcoholics were also subjected to a percutaneous liver biopsy that showed moderate to severe histological liver damage in 46 subjects (44%). No differences in the studied genetic markers, were found among the four groups. It is concluded that this study does not confirm previously reported associations between genetic markers and alcoholic liver disease.
  • Publicacion
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    Nutrition and education. II. Educational achievement and nutrient intake of Chilean elementary and high school graduates.
    (1991-12-01)
    Daniza Ivanovic
    ;
    ;
    Macarena Marambio
    ;
    D Ballester
    ;
    Isabel Zacarías
    The interrelationships between educational achievement (EA) and nutrient intake were investigated in 550 Chilean adolescent schoolers graduating from elementary and high school. The random sample included schoolers from both educational levels (1:1), from public and private schools (1:1), and from high, medium, and low socioeconomic status (SES) (1:1:1). Standard procedures for 24-hour dietary recall interviews were used to collect data, and adequacy of intake was assessed by the FAO/WHO Pattern. EA was measured by means of the Achievement Evaluation Program (AEP) and Academic Aptitude Test (AAT) in elementary and high school, respectively. In elementary school graduates, results showed a significant and positive correlation between EA (AEP) and energy, protein, riboflavin, ascorbic acid, calcium and vitamin A intake (Multiple r = 0.456 p less than 0.01; r2 = 0.208). The School Feeding Program beneficiaries who belonged to the low SES presented the lowest EA (AEP) together with a deficient nutrient intake, especially for energy, riboflavin, niacin, vitamin A and calcium, at the same time that they registered the lowest values for those anthropometric parameters, indicators of past nutrition, that is to say height-for-age, weight-for-age, head circumference-for-age and a higher upper-to-lower segment ratio, as compared with non-beneficiaries from the same SES and with those from the higher strata. In high-school graduates, EA (AAT) was found to be significantly and positively correlated with protein, calcium, riboflavin and iron intake (Multiple r = 0.438 p less than 0.001; r2 = 0.192). Nevertheless, these interrelationship are strongly related to SES and sex. Results showed that educational achievement (EA) is significantly and positively associated with nutrient intake, this fact being important for educational planning related to the School Feeding Program.
  • Publicacion
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    Nutrition and education. III. Educational achievement and food habits of Chilean elementary and high school graduates.
    (1992-03-01)
    Daniza Ivanovic
    ;
    ;
    M Aguayo
    ;
    D Ballester
    ;
    Macarena Marambio
    The objective of this study was to correlate the educational achievement (EA) of Chilean elementary and high-school graduates with their food habits. For this purpose, a random sample of 550 schoolers from the Metropolitan Area of Santiago, Chile, graduating from elementary and high school (1:1) of both sexes (1:1), from public and private schools and from high, medium and low socioeconomic status (SES) (1:1:1), was selected. Food habits were determined through a specially designed questionnaire and defined as the frequency of consumption of the food groups, expressed as days per week. The EA was established through the Achievement Evaluation Program (AEP) and Academic Aptitude Test (AAT) in elementary-and high-school graduates-, respectively. Results revealed that EA was found significantly and positively correlated with the frequency of consumption of dairy products, meat products and eggs, in both elementary and high school graduates. A significant and inverse correlation between EA and the frequency of vegetables and fruits consumption was observed in both educational levels, and with miscellaneous products, only in elementary school graduates. Food habits explained 24.4% and 16.6% of the EA variance, in elementary and high school graduates, respectively. The frequency of consumption of dairy products was the independent variable with the greatest explanatory power in EA variance (approximately above 70% of the explained variance). These results are important to consider for educational planning focused on the School Feeding Program.
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    [Adiposity and fat distribution in preschool children from low socioeconomic levels in Caracas].
    (1997-03-01)
    Pérez Bm
    ;
    ;
    Maritza Landaeta‐Jiménez
    ;
    Guillén Ramírez
    ;
    Thaís Ledezma
    Epidemiological studies suggest that body fat distribution in adults is associated with chronical nontransmissible diseases, less is known during the growing years. The current study was undertaken to explore the relationship between level of fatness, fat patterning and some socioenvironmental variables in a group of 449 children aged 3 to 6, living in Caracas, who belong to the poorest Venezuelan socio-economic stratum. Data was analyzed taking nutritional status (weight-for-age), an index of socioeconomic conditions (ICSA), sex and age, as control variables. Using a multivariate analysis we derived first, two groups of households (G1 and G2) as determined by socioeconomic variables, to which principal component analysis was applied to elicited fatness and relative fat patterning through six skinfolds. First component identify level of adiposity, second extremity/trunk fatness, and third upper/lower pattern. Comparison of normal children with those of low weight-for-age showed differences in adiposity and in the upper/lower patterning as detected by the skinfolds involved in the differences: subscapular (-0.53) and supraspinale (0.32) in children with low weight-for-age; triceps (-0.46) and thigh (0.29) in those classified as normal. We found that gender, nutritional condition, environmental variables and age, were significant predictors of the differences in adiposity level; while age and households conditions, appear to be related to upper/lower patterning. The data equally suggests that body fat is more centrally distributed in boys with low weight-for-age. Since these patterns are indicators of risk in the ongoing years, we call tha attention about environmental circumstances.