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La desnutrición se acompaña de modificaciones importantes en los niveles hormonales plasmáticos como parte de sus mecanismos adaptativos que permiten la sobrevida; devido al alto índice de desnutridos en nuestro medio, la motivación para esta investigación fue conocer como se comportan nuestros pacientes en relación a lo descrito en la literatura. Se evaluaron 20 niños desnutridos graves (13 Kwashiorkor y 7 Marasmo-Kwashiorkor) en edades comprendidas entre un mes y tres años, al ingreso, a los 15 días, al mes y a los dos meses de la recuperación. Las variables estudiadas fueron: edad, antropometría, escore de McLaren, niveles hormonales plasmáticos (Hormona de Crecimiento, IGF-1). Al ingreso los valores de hormona de crecimiento fueron elevados, disminuyendo significativamente (p<0,05) a los dos meses de la rehabilitación nutricional, en contraste los niveles de IGF-1 fueron bajos al ingreso, aumentando significativamente (p<0,05) a los dos meses de la recuperación. Los niveles altos de hormona de crecimiento pudieran ser explicados por la ausencia de retrocontrol ejercido normalmente por los niveles de IGF-1 que se encuentran disminuidos. El mejor entendimiento de los cambios hormonales en la desnutrición podrá conducir al uso terapeútico de ciertas hormonas tanto en la rehabilitación nutricional como en efermedades acompañadas de desnutrición

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Duodenal ulcer is a multifactorial entity where a genetic predisposition and extrinsic elements seem to concur in its origin. A series of genetic and extrinsic markers were determined in 50 patients with duodenal ulcer and 50 controls matched by age, sex and socioeconomical status. HLA antigens dit not have significant differences. Blood group O Rh+ was predominant (p < 0.01). Secretor status of antigen HBO in saliva was positive in 70% of patients (p < 0.001). Serum Pepsinogen I was increased in 85% of cases (p < 0.001). Immunoglobulin G anti H. pylori was positive in 62% of ulcerous (p < 0.001). The highest sensibility and negative predictive value was represented by increased serum pepsinogen levels (85%); the highest specificity and positive predictive value was to Ig G anti H. pylori (90 and 86%). These results affirm the polygenic character of the duodenal ulcer disease.

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Absolute and corrected by creatinine excretion urinary Epidermal Growth Factor (EGF) values were determined in 23 duodenal ulcer patients and compared to a control group. Basal serum pepsinogen I levels were measured in the patient group. Absolute urinary EGF values in patients were lower than in control group, such difference however, as such of EGF corrected by urinary creatinine excretion were not statistically significant (p > 0.05). Absolute urinary EGF excretion in male patients was higher than in female patients (p < 0.05), but after establishing the ratio EGF/Creatinine, the difference disappeared. There was no correlation between EGF and Pepsinogen I, it was inverse with age and positive with creatinine excretion. Some mechanisms are considered to explain the urinary EGF normality in these patients. The increasing importance given to EGF in ulcerous diseases and further trends in research are analyzed.

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An adequate propranolol dose to reduce 25% the initial heart rate was searched in 19 children with portal hypertension. 13 were pre-hepatic and 6 hepatic hypertension, mean age: 6.96 +/- 3.48 years, range: 2-14 years. Treatment was started with 0.5 mg/kg/day increasing 0.25 mg/kg/day every third day, needing an average of 26 +/- 13 days (range: 6-54 days) to obtain the response. Daily dose ranged from 1 to 5.25 mg/kg/day (mean: 2.69 +/- 1.16). The highest daily dose was 175 mg, the lowest 23.4 mg (mean: 58.27 +/- 36.6 mg/day). Some parameters were evaluated before and after achieving the dose. There was a significant reduction of mean blood pressure (p < 0.01) and peripheral venous pressure (p < 0.05) in 68.4% of patients. A significant elevation (p < 0.001) of 24 hour urinary catecholamine levels occurred in 94.7%. Side effects were minimal. Propranolol could be considered a safe pharmacological option in these patients.

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Hyperpepsinogenemia I is a reliable subclinical marker of the genetical predisposition to suffer duodenal ulcer. For that reason we determine basal serum pepsinogen I (PG I) levels in 25 ulcerous patients and 75% of their offspring and to a control group matched by age and sex. PG I levels in patients and their offspring were significantly higher than those in controls and their offspring (p < 0.001). By establishing an upper normal value of PG I, we identified a subpopulation of normopepsinogenemic ulcerous patients and another with high values (9 normo PG I: 64.3 +/- 6.2 ng/ml vs 16 ulcerous patients with PG I levels: 142.1 +/- 19 ng/ml) (p < 0.001). Of 16 hyperpepsinogenemic patients, 11 offspring (27%) had increased values, what did not happen to any of the offspring of ulcerous patients with normal PG I or control group finding that 80% of male patients with high PG I gave birth to 1 or 2 children with increased values, suggesting a transmission thorough the male character. So gentic role plays an important place in our ulcerous patients but environmental factors appear to decisively influence on the establishment of the disease.

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To provide normative data, we measured anogenital distances in 115 infants of 25 to 42 weeks gestational age and 10 pregnant women, including anus to fourchette (AF), anus to base of the clitoris (AC), and fourchette to base of the clitoris (FC). All infant measurements showed positive and significant correlations with body surface area, weight, length, and gestational age (P less than 0.001). However, the anogenital ratio (AF/AC) followed a normal distribution and did not correlate with any of the anthropometric variables or age. Mean (+/- SD) value in infants was 0.37 +/- 0.07, and in adults, 0.36 +/- 0.07. An anogenital ratio greater than 0.50 falls outside the 95% confidence limits, suggests labioscrotal fusion, and indicates a need for further evaluation. Because it is independent of body size and gestational age, the anogenital ratio should be useful in diagnosing androgen-induced labioscrotal fusion in both premature and full-term female infants.

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The plasma renin activity (PRA) was determined by radioimmunoassay in 102 subjects with normal blood pressure. In this group, 56 were female and 46 male, their ages ranged between 13 and 90 years, they were not receiving any medication and their diet contained normal amounts of sodium and potassium. In addition to the PRA measurements, their weight, height, blood pressure, hemoglobin, hematocrit, serum and urinary sodium, potassium, chloride as well as proteinuria and creatinine clearance were studied. A significative correlation was found between the PRA and age. However, no correlation was found between PRA and urinary sodium. The subjects were also divided in three groups: I. less than 30 years old. II. between 30 and 60 years old, and III. over 60 years. A significative correlation between PRA and urinary sodium was found in group II. These results in group II could be explained by the finding of a daily urinary sodium excretion below 250 mEq. Age has a definite influence between PRA and urinary sodium. We found that important changes in the response of the yuxtaglomerular apparatus to the intake of sodium develop around the age of 60. In group II is where we found a more stable equilibrium in PRA. In group I, the response of the PRA to a low intake of sodium was faster and violent, where as in group III the response was slower. Finally we think it is very important in these type of studies to follow very strict methodology, because it is the only way to establish comparisons between the different ethnic groups.

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