[Urinary epidermal growth factor and serum pepsinogen I in patients with duodenal ulcers]

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.

[Propranolol in children and adolescents with portal hypertension: its dosage and the clinical, cardiovascular and biochemical effects]

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.

[Main drug interactions at a hospital emergency department. Analysis of 100 cases]

We prospectively reviewed clinical charts of 100 consecutive patients that were admitted during the first trimester 1991 to the Emergency Department of a general hospital in order to determine the more frequent prescribed drugs and their interactions using a computer program (Drug Interaction Program), emphasizing in those drugs used to treat peptic ulcers. Number of drugs prescribed to each patient was 4.20 +/- 1.39. Antacids (39%) and cimetidine (35%) occupied the third and fourth place. There were interactions in 79 patients and in 66 of them (84%) they were important. Antacid and cimetidine were similarly prescribed, but of 35 patients who received cimetidine only 3 (8.5%) had a primary indication for its use (Gastrointestinal bleeding). Significant clinical interactions of cimetidine with other medications are analyzed. Our results indicate that drug interactions are a permanent risk in our hospitals. We suggest to use a computer program on drug interactions or an updated chart of medications in the emergency rooms of our hospitals.

[Delay of gastric emptying in dyspeptic patients: a study with radiopaque markers]

We studied the gastric emptying of indigestible solids after the ingestion of radiopaque markers in 9 control subjects, 9 insulin-dependent diabetics and 9 dyspeptic patients. Along with a breakfast each individual swallowed 10 markers made of intravenous catheters filled with barium, then flat films of abdomen were taken 1, 2, 4 and 6 hours later. At fourth hour, all controls had emptied their markers, 11% of diabetics and 22% of dyspeptic patients (p < 0.001). By 6 hours, 33% of diabetics and 55% of dyspeptic subjects had emptied them (p < 0.001, p < 0.05). At 4 hour controls had discharged 10 markers, diabetics 2.5 +/- 0.6 and dyspeptic 4.9 +/- 0.7. By 6 hours diabetics emptied 4.9 +/- 0.7 and dyspeptic patients 7.9 +/- 0.6 markers. Through this reliable method, an evident delay of gastric emptying in diabetics and a good proportion of dyspeptic patients is showed.

[Serum cationic trypsinogen: marker of exocrine pancreatic dysfunction in children with protein-calorie malnutrition]

Serum cationic trypsinogen, a non invasive, sensitive test to evaluate the exocrine pancreatic function was measured by radioimmunoassay in 31 children with different degrees of protein-calorie malnutrition (mild, moderate, severe) in whom mean serum albumin values were 3.7 +/- 0.7 g%; 3.1 +/- 0.9 g%; 2.3 +/- 0.4 g%, respectively and in a control group of 20 well-nourished children with mean serum albumin values of 3.9 +/- 0.7 g%. Mean serum trypsinogen levels were significantly elevated in children with malnutrition (mild: 28.5 +/- 2.4 ng/ml, moderate: 31.86 +/- 3.4 ng/ml, and severe: 36.52 +/- 7.8 ng/ml) compared with the mean values in the control group (17.7 +/- 2 ng/ml). (p < 0.001). We conclude that our results suggest evidence of a pancreatic damage in malnourished children and this disfunction increases according to the degree of malnutrition, allowing to be detected with this simple test even when the patient does not present qualitative steatorrhea.