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Endoscopic extraction of digestive foreign bodies Introduction: The ingestion of a foreign body (FB) is very common in childhood, 10 to 20% of the cases require endoscopic removal. The aim of this study is to analyze the demographic, clinical and endoscopic characteristic of patients with FB ingestion requiring endoscopic management. Patients and Methods: The design corresponded to a Prospective Cohort Study. It included patients referred to the Clinica Alemana ER in Santiago in order to remove foreign bodies from their digestive systems between November 2007 and No-vember 2011. Demographic, clinical and endoscopic characteristics were recorded, classifying the symptoms as respiratory, digestive and other manifestations. Risk factors and complications were evaluated. Results: 170 patients, 52.4 % male with average age of four years and three months old. In 78.5 % of the cases, the FB ingestion occurred at home, 82.1% sought medical attention within two hours from the ingestion. Digestive, respiratory and local pain were among the most common symptoms. The location of the FB took place using simple x-ray in 87.6 % of the cases. 91.8% of the FBs were extracted. Location: retropharyngeal 1.3%, 69.3% esophagus, stomach 23 %, duodenum 1.9 % and 3.8 % distal duodenum. Round FB were the most frequent (56.4%) like coins, sharp objects (24.1%), batteries (14.7%), magnets (2.9%) and other large items (1.8%). Mucosal lesion was found in 53.5% of the cases and 9.8% required hospitalization Conclusions: The ingestion of FB occurred at home, and it is most frequent in preschool children. The most common FB was a coin. The location of the FB was through x-ray and no failure or complications were described during the endoscopic removal.(Key words: Foreign body, endoscopic extraction, pediatric age, accidents).Rev Chil Pediatr 2013; 84 (5): 505-512RESUMENIntroduccion: La ingestion de cuerpo extrano (CE) es frecuente en la infancia, requiriendo en el 10-20% de los casos extraccion endoscopica. El objetivo de este trabajo fue analizar las caracteristicas demograficas, clinicas y endoscopicas de los pacientes con ingesta de CE que requieren manejo endoscopico. Pacientes y

La Diarrea Crónica, definida como aquella que se prolonga por más de 4 semanas, es motivo común de consulta al Pediatra y Gastroenterólogo infantil. Las causas son muy variadas y dependen principalmente de la edad del paciente. En menores de 6 meses, predominan las anomalías congénitas y las alergias alimentarias; en preescolares aparecen las intolerancias a disacáridos, giardiasis, diarrea inespecífica y tumores; en escolares se agrega la Enfermedad inflamatoria intestinal. A cualquier edad debe considerarse además, la etiología infecciosa y en ciertas circunstancias la Enfermedad celíaca. El estudio debe ser sistemático y progresivo, orientado por la historia clínica. Se inicia con una evaluación del estado nutricional y con exámenes generales destinados a descartar infección y evaluación de las funciones digestivas y absortivas. Luego, en algunos casos, se requerirá de estudios más específicos a cargo del especialista. El tratamiento debe enfocarse en preservar un adecuado estado nutricional del paciente, mientras se toman medidas terapéuticas específicas cuando corresponda. La Diarrea crónica debe inicialmente ser manejada por el Pediatra general y cuando sea necesario se requerirá de la participación del Gastroenterólogo infantil en Centros de Salud de mayor complejidad.

Background: Ample use of serological markers of high sensitivity and specificity led to relevant changes in the epidemiology of celiac disease. The impact of these changes in our country is poorly known. Aim: To assess the diagnostic procedures, clinical presentations and follow up of celiac disease as conducted in current pediatric practice. Material and methods: A multicentric retrospective study of patients diagnosed between 2000 and 2005 in five pediatric hospitals in Santiago, Chile. Data was obtained from clinical records, recorded in electronic spreadsheets and analyzed by descriptive statistics. Results: Seventy four of 83 identified patients fulfilled the inclusion criteria and were analyzed. Mean time to reach the diagnosis was 2.1 years. Cases younger than 10 years presented digestive manifestations such as chronic diarrhea and abdominal distension. Twenty one percent of older patients had atypical presentations (mainly short stature, refractory anaemia). Ten percent of cases were screened because a first degree relative had celiac disease. All patients had significant duodenal/jejunal lesion. IgA-antiendomysial antibodies (n =65) and IgA-antigliadin antibodies (n =23) were the most commonly used screening tests used but often, they were not available for follow up. A second biopsy was planned in all patients but only 26 had it due to repeated dietary transgressions, often due to unnoticed consumption of gluten in poorly labeled products. Conclusions: Digestive manifestations were the main presentation form for celiac disease among patients under 10 years of age. Atypical symptoms become relevant in patients older than 10 years. Antiendomysial and antitransglutaminase antibody measurement should be incorporated for routine screening and follow up of celiac disease in public hospitals. To improve food labeling about their gluten content is needed (Rev Med Chile 2008; 136: 296-303).

To investigate the efects of copper-deficiency on spontaneous closure of ductus arteriosus in newborn rats,an experimental model consisting in three groups of ten female Sprague-Dowley rats each was used. Group I rats,copper-deficient, were fed a copper-free diet from 35 days before pregnancy until birth. Group II, control rats,were given a diet containing appropriate amounts of copper [6 ppm) and energy. Group III, the pair-fed rats, receiv-ed a diet that was adecuate in copper content but restricted in energy to the same caloric ingestion previouslyshown by copper deprived rats. The ductus arteriosus of 10 newborn rats of each group were studied by hystologicalmethods at sometime between the third and twelfth hour of life, and it was patent in 100%, 20% and 40% of thecases of copper deprived, control and pair fed rats respectively (Chi square test, p — 0-0009)- The wall thickness ofpatent ductus from copper deprived rats were significantly lower than those from rats of the other two groups(Kruskall-Wallis Test; p = 0.0079). Our results suggest that materno-fetal copper deficiency significantly affects thespontaneous closure rate of the ductus arteriosus in the rat. The mechanism of this abnormal response probablyincludes structural changes in the ductal wall, alterations in the energy yield process or abnormal regulation ofprostaglandins E2 and F2 —asynthesis,(Key words: Patent ductus arteriosus, copper-deficiency, rats.)

Nitrogen, fat and energy retention were measured in 10 male infants (mean age = 6.8 mo) recovering from marasmic malnutrition while they were fed with either cow's milk based formula (LP) or a modified cow's milk formula (LPM). Their mean weight for age ratio was 72% and their weight for length ratio was 95% (NCHS standards). They went through two consecutive balance periods of 6 days each (3 d. for adaptation and 3 d. for urine and feces collection) beginning with either formula randomly. Both formulas had 85 kcal/dl with 11% protein calories in LPM and 13% in LP. Energy intake, absorption and relative retention were slightly greater with LPM than LP. Fat intake was greater under LPM than LP (5.4 vs. 4.5 g-kg-d, p < 0.025), which resulted in significant differences in fat absorption (LPM 4.3 vs. LP 3 g-kg-d, p < 0.025). Nitrogen intake was significantly lower under LPM than LP (487 vs. 571 mg-kg-d, p < 0.025) with lower urinary nitrogen excretion for LPM than for LP (304 vs. 417 mg-kg-d, p < 0.001). Apparent nitrogen retention averaged 115 mg-kg-d for LPM and only 69 mg-kg-d for LP (NS). A significant correlation was observed between nitrogen intake and nitrogen retention: r = 0.70 (y = 0.57x -167; p < 0.05) with LPM, and r = 0.77 (y = 0.63x -291, p < 0.01) with LP. A correlation was also found between energy intake and weight gain: r = 0.55 (NS) with LPM, and r = 0.88 (y = 0.26x -26; p < 0.001) with LP.(ABSTRACT TRUNCATED AT 250 WORDS)