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Coeliac disease is generally considered to be a disease of Europe, North America, and Australasia. A series of well-authenticated cases from Cuba is presented. One of the factors responsible for the presence of this disease in Cuba may be the increase in wheat consumption in the last few years. It is likely that coeliac disease exists in other tropical countries. [ABSTRACT FROM AUTHOR] more...

The use of secretin to facilitate the demonstration of Giardia lamblia in duodenal juice was studied in children under investigation for chronic diarrhoea. 30 children aged 3 months to 13 years, whose stools were negative for G. lamblia, were studied. G. lamblia was demonstrable in a sample of duodenal juice in 1 of the 30 children before an intravenous injection of secretin (1 or 2 mg/kg), but in 9 of the 30 children after secretin. It is concluded that examination of duodenal juice after secretin stimulus is an effective method of showing giardial infestation. [ABSTRACT FROM AUTHOR] more...

Background: Patients with a history of adverse childhood experiences (ACEs) have a higher incidence of developing autoimmune diseases such as systemic lupus erythematosus., Objective: The objective is to associate the ACE with the clinical manifestations of SLE in adult women., Methods: This is a cross-sectional observational analytical study in a sample of women diagnosed with SLE, whose data were collected through interviews and a review of medical records. The ACE were identified using the Childhood Trauma Questionnaire (CTQ) and were associated with sociodemographic and clinical data, as well as the presence of harm., Results: The sample was composed of 97 women. In this study, significant associations were found between physical abuse and oral ulcers ( p = .006) and nephritis ( p = .032); between sexual abuse and Sjogren's syndrome ( p = .024) and oral ulcers ( p = .035); between physical neglect and photosensitivity ( p = .024) and oral ulcers ( p = .039); and between emotional neglect and diabetes mellitus ( p = .033)., Conclusion: Individuals with a positive history of ACE have significant associations with certain clinical manifestations of SLE and subtypes of ACE, underscoring the importance of preventing childhood trauma to improve adult health. Further studies are needed to elucidate the impact of ACE on adult health., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. more...

Background: Systemic Lupus Erythematosus (SLE) predominantly affects young females who are in their most productive years of life. SLE can cause organ damage and affects daily functioning and quality of life, causing work disability (WD)., Methods: We developed a longitudinal study with 110 SLE patients, whose data were collected through individual standardized interview and review of medical records. We aimed to determine the prevalence of WD and its possible associated risk factors (sociodemographic, lifestyle habits, quality of life, clinical characteristic, cumulative organ damage and disease activity). To identify variables associated with work disability, two different multivariate regression models using a stepwise backward method were performed., Results: The percentage of WD due to SLE was 76.3%. An association was found between WD and lack of physical exercise (p=0.017) and high physical work demand (p=0.037). Clinical characteristics were not significant predictors of work dysfunction., Conclusion: 76.3% of our sample developed WD after SLE diagnosis. Participants who did not practice physical exercise and those who had a high-demand physical work were, respectively, 3.78 and 4.80 times more likely to have WD. Although we were not able to analyze the influence of COVID-19 in WD development, COVID-19 pandemic could have exacerbated the inequalities among people with chronic health conditions, especially in a low-income population, which could have influenced our results. Additional researches to evaluate risk factors for WD in low-income SLE patients and on strategies for reducing its impact are needed. more...

Biological and medical sciences are increasingly acknowledging the significance of gene co-expression-networks for investigating complex-systems, phenotypes or diseases. Typically, complex phenotypes are investigated under varying conditions. While approaches for comparing nodes and links in two networks exist, almost no methods for the comparison of multiple networks are available and-to best of our knowledge-no comparative method allows for whole transcriptomic network analysis. However, it is the aim of many studies to compare networks of different conditions, for example, tissues, diseases, treatments, time points, or species. Here we present a method for the systematic comparison of an unlimited number of networks, with unlimited number of transcripts: Co-expression Differential Network Analysis (CoDiNA). In particular, CoDiNA detects links and nodes that are common, specific or different among the networks. We developed a statistical framework to normalize between these different categories of common or changed network links and nodes, resulting in a comprehensive network analysis method, more sophisticated than simply comparing the presence or absence of network nodes. Applying CoDiNA to a neurogenesis study we identified candidate genes involved in neuronal differentiation. We experimentally validated one candidate, demonstrating that its overexpression resulted in a significant disturbance in the underlying gene regulatory network of neurogenesis. Using clinical studies, we compared whole transcriptome co-expression networks from individuals with or without HIV and active tuberculosis (TB) and detected signature genes specific to HIV. Furthermore, analyzing multiple cancer transcription factor (TF) networks, we identified common and distinct features for particular cancer types. These CoDiNA applications demonstrate the successful detection of genes associated with specific phenotypes. Moreover, CoDiNA can also be used for comparing other types of undirected networks, for example, metabolic, protein-protein interaction, ecological and psychometric networks. CoDiNA is publicly available as an R package in CRAN (https://CRAN.R-project.org/package=CoDiNA)., Competing Interests: No competing interests. more...

We investigated whether maternal intake of normolipidic diets with distinct fatty acid (FA) compositions alters the lipidic profile and influences the inflammatory status of the adult offsprings׳ brains. C57BL/6 female mice during pregnancy and lactation received diets containing either soybean oil (CG), partially hydrogenated vegetable fat rich in trans-fatty acids (TG), palm oil (PG), or interesterified fat (IG). After weaning, male offspring from all groups received control diet. The FA profile was measured in the offspring׳s brains at post-natal days 21 and 90. Brain functional capillary density as well as leukocyte-endothelial interactions in the cerebral post-capillary venules was assessed by intravital fluorescence microscopy at post-natal day 90. Inflammation signaling was evaluated through toll-like receptor 4 (TLR4) content in brain of the adult offspring. In the 21-day old offspring, the brains of the TG showed higher levels of trans FA and reduced levels of linoleic acid (LA) and total n-6 polyunsaturated fatty acids (PUFA). At post-natal day 90, TG and IG groups showed reduced levels of eicosapentaenoic acid (EPA) and total n-3 PUFA tended to be lower compared to CG. The offspring׳s brains exhibited an altered microcirculation with increased leukocyte rolling in groups TG, PG and IG and in TG group increased leukocyte adhesion. The TLR4 content of TG, IG and PG groups only tended to increase (23%; 20% and 35%, respectively). Maternal consumption of trans FA, palm oil or interesterified fat during pregnancy and lactation can trigger the initial steps of inflammatory pathways in the brain of offspring in adulthood., (Copyright © 2015 Elsevier B.V. All rights reserved.) more...

Virulence factors of Helicobacter pylori can predict the development of different gastroduodenal diseases. There are scarce reports in Cuba about H. pylori isolates genotyping. The aim of the present investigation was to identify allelic variation of the virulence genes vacA, cagA, and iceA in sixty-eight patients diagnosed as H. pylori positive by culture. In seven out of 68 patients, strains from both gastric regions were obtained and considered independent. DNA was extracted from all the H. pylori strains and evaluated by PCR-genotyping. The vacA s1 allele, cagA gene, and iceA2 allele were the most prevalent (72.0%, 56.0%, and 57.3%, respectively). Alleles from m-region showed a similar frequency as s1a and s1b subtypes. The presence of multiple H. pylori genotypes in a single biopsy and two gastric region specimens were found. Significant statistical association was observed between iceA2 allele and patients with non-peptic ulcer dyspepsia (NUD) (P = 0.037) as well as virulence genotypes (s1, s1m2) and patients over 40 years old (P < 0.05). In conclusion, the results demonstrated a high prevalence of H. pylori virulent genotypes in Cuban patients over 40 years old while iceA2 alleles demonstrated a good specificity in patients with NUD. more...

Celiac disease (CD) susceptibility has been strongly associated with HLA-DQ2 and HLA-DQ8. The main objective of this study was to assess the distribution of HLA DQA1*0501 and DQB1*02 alleles (DQ2) for the first time in a group of Cuban celiac patients. We evaluated 22 patients, 54 first-degree relatives, and 60 controls for detection of antitissue transglutaminase (tTG)-specific antibodies in serum. We found that 100% of the probands and 19% of the first-degree relatives were positive for the antibodies in serum. We did not detect any specific response for the healthy control individuals. We observed a significant over-representation of DQ2 heterodimer, both in patients and relatives. In the group of patients, 86.3% were positive for DQA1*0501, 90.2% were positive for DQB1*02, and 86.3% were positive for both alleles. The frequencies in relatives and controls were as follows: 70%, 90%, and 70%; and 56.6%, 45%, and 20%, respectively. In conclusion, we found that the proportion of our celiac patients carrying DQ2 was similar to the proportion of CD patients reported in populations with different genetic backgrounds. These results underline the primary importance of HLA-DQ alleles in susceptibility to celiac disease. more...

Liver biopsies from 27 patients with malignant diseases and virus B carriers state were studied. The age of the patients ranged from 2 to 14 years. ELISA tests for virus B hepatitis were performed in all patients. Three of them resulted HBV positive at admission, whereas 24 became positive after anti-tumoral treatment onset. One patient was also virus C positive. Morphological disorders findings comprises: symptomless acute hepatitis in 7 patients (including the B-C carrier), minimal hepatocytes damage was found in 17 patients as the result of their carriers state and where also certain drug-induced hepatotoxic effect might be present. In this group there were also 7 biopsies with minimal portal region damage. Three biopsies were reported as normal liver tissue. This results confirmed the significance of the study of serological hepatitis viral test and hepatic biopsy in high risk group patients, where it is also necessary the vaccination against HBV before treatment onset. more...

The current concepts in persistent diarrhoea (PD) are reviewed. 102 patients with acute diarrhoea and 85 with PD are studied. All were less than one year old. Information about age, nutritional status, time of breast feeding, previous episodes of acute and persistent diarrhoea and the previous use of drugs is registered. Microbiological and parasitologics studies were done to identify enteric pathogens. To prove the association of PD and the exposure to different risk factors the statistic method of Chi square (chi 2) was used and the odds ratio (OR) estimated. In order of importance and according to the OR the risk factors identified were: previous episodes of PD, malnutrition, less than one month with breast feeding, the use of metronidazol and antibiotics, multiple infections, previous episodes of acute diarrhoea and the identification of enteric pathogens. The most frequent pathogen was Salmonella followed by entero pathogenic Escherichia coli. more...

30 patients (less than 15 years old) were admitted for esophageal strictures, 16 of them secondary to corrosive injury. All the patients were treated with endoscopic dilatation with Savary-Gilliard bougie. The dilations were done with general anesthesia using an Olympus GIF-XP10 endoscope and with fluoroscopic control. In the esophageal stenosis secondary to caustic ingestion endoscopic injection with Betamethasone was also used. The most frequent site of the stenosis was the upper third of the esophagus, and the main type of stenosis was tubular in the secondary to caustic burns and annular in the other group. In the post-caustic group 385 dilations were performed in 115 sessions. In the other group 159 dilations were done in 51 sessions. Two perforations and one sepsis were reported in patients with corrosive stenosis. There was no mortality. 43.7% of the patients with corrosive stenosis and 85.7% with stenosis secondary to other causes obtained complete healing. Esophageal dilation with Savary-Gilliard bougies represents a safe and reliable method for the treatment of esophageal strictures. more...

The evolution of some nutritional anthropometric indicators was studied in a 115 breast-feeding infants (52 received breast-feeding during the first four months of life (120 days) exclusively and 63 mixed feeding). Breast feeding infants showed sustained weight increment during the four weeks of evolution. The multivariate repeated measures analysis performed, proved significant changes during evolution's time in all studied indicator in lineal form, as well as interaction between type of feeding and indicators evolution except the subescapular fat fold. Author concluded that it should be reinforced the breast-feeding practice promotion as an effective way for the nutritional recovery of breast-feeding infants with persistent diarrhoea. more...

75 patients, less than one year old, admitted in our Hospital, from January 1991 to april 1992 were divided in three groups: Group I: 25 controls, group II 25 patients with acute diarrhoea and group III 25 patients with persistent diarrhoea. The serological status of vitamin A was evaluated and classified as normal, not severe deficiency and severe deficiency. It was demonstrated that vitamin A deficiency is a risk factor for persistent diarrhoea. more...

Alagille's syndrome or arteriohepatic dysplasia has been described in Cuba in nine patients between nine months and 12 years of age (8 males and one female). Among the clinical features we found five major abnormalities: chronic cholestasis with neonatal jaundice (9/9), peculiar facies (9/9), peripheral pulmonary artery hypoplasia associated with cardiac murmur (6/9), butter-fly-like arch defects (4/9), and posterior embryotoxon (6/7). Two children had a severe xanthomatosis. Laparoscopy showed green hepatomegaly depending on the degree of cholestasis, and only one patient had incipient signs of micronodular cirrhosis. Liver histology showed a paucity of interlobular bile ducts. Survival was of 60%. One patient survived more than 30 years. Four patients died of liver carcinoma (unique report in infants), broncho-pneumonia, acute renal failure, and sudden death respectively. Among the minor features were mental retardation (5/9), a peculiar voice (3/9), growth retardation observed in some of our patients. This is the first report on Alagille's syndrome in Latin America, because so far reports have come only from Europe and North America. more...

During the last decade, a number of epidemiological and laboratory investigations have shown a close association among hepatitis B, dietary exposure to aflatoxin, and an increased incidence of hepatocellular carcinoma. An immunoenzymatic method for aflatoxin detection in urine was developed and assessed at the National Institute of Oncology. Fifty four children (age range 4-16 years) from the pediatric service at the National Institute of Gastroenterology were studied. Thirty patients had a diagnosis of chronic active hepatitis (CHA 17 of which 56%) were found aflatoxin- positive, 20 where HbsAg-positive carriers of which 7 of 35% were positive to aflatoxin, and 4 patients suffered from metabolic diseases from which 1 (25%) was found aflatoxin- positive. Controls and patients were matched by age, with 7.5% of aflatoxin-positive patients. Our results confirm the link between hepatitis B and aflatoxin in this type of patients compared to controls. The immunoenzymatic system proved to be specific for aflatoxin detection with a sensitivity of 100 picograms/milliliter. more...

The results of a clinic assay with an extract made out of propolis (bee glue) or "Propolisina" were showed with the aim of showing its effectivity against giardiasis. One hundred and thirty eight patients were studied 48 children and 90 adults, in 2 groups and they selected aleatorily to be treated with "Propolosina" or an imidazole derivate (tinidazole). The method for an exact diagnosis in children was duodenal aspiration and in adults duodenal mucosa frotis by means of duodenoscopy. Similar studies were carried out as a cure criterium in a 5-day term after being through with the treatment. Propolisina was used with different concentrations: in children (concentration at 10%) results showed a 52% cure. In 40 adults (concentration at 20%) it was obtained a similar result to that of tinidazole; and when propolisina concentration was elevated at 30% in the remaining 50 patients there was a higher effectivity (60 of cure Vs 40% with tinidazole). This work shows the success of this natural product, which is very easy to obtain in Cuba and with no side effects in the treatment of this intestinal parasitism, what is of great economical importance for our countries. more...

Two hundred children hospitalized in the National Institute of Gastroenterology were studied during the 1972-1980 period. The children, whose ages ranged between six months and ten years, presented chronic diarrhea in which Giardia lamblia was considered the causative agent. The diagnosis of parasitism was made with the detection of Giardia lamblia in the feces and/or duodenal content. A serum D-Xylose and jejunal biopsy were performed on all the patients and the histology of the mucosa was classified in keeping with the degree of atrophy according to Metayer and Laumonier. In our study we divided the patients into three groups: Group 1, parasitism due to Giardia lamblia in patients with a normal D-xylose and different degrees of atrophy of the jejunal mucosa, but with normal D-Xylose and Group 3, malabsorption due to Giardia lamblia, with a pathological D-Xylose and alterations in the intestinal mucosa. There were 35 cases in Group 1 (17.5%), 91 cases in Group 2 (45.5%) and 74 cases in Group 3 (37%). The predominant intestinal lesion was partial atrophy of the villi (143), 20 with subtotal atrophy of the villi and two with complete atrophy of the villi. It was shown that the host's response to infection by Giardia lamblia varies with differing effects on the structures and functioning of the jejunal mucosa. It is important to group patients with chronic diarrhea due to Giardia lamblia in this way since it allows for and individualized clinical approach and provides a prognosis in terms nutritional consequences resulting from possible persistence of the diarrhea and possible associated lactose intolerance. more...