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      Valores normales de la prueba sudan III en niños sanos menores de un año de edad Translated title: Normal range for sudan III test in under children under one year of age

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          Abstract

          La esteatorrea es la pérdida de grasa en las heces. Se manifiesta clínicamente con heces fétidas, grasosas y abundantes. Se puede determinar por el método Van de Kamer, el esteatocrito acidificado y la tinción sudan III en heces. El objetivo del presente trabajo es precisar el valor normal de la prueba Sudan III en heces. Material y Métodos. Se incluyeron las muestras de heces de 2000 niños sanos (recién nacidos pre- término, recién nacidos a término, lactantes de 1-4 meses y de 5-12 meses de edad) ,500 muestras por grupo. Se realizó en el Hospital Universitario de los Andes, en Mérida- Venezuela, durante los años 1999-2009. En la prueba se utilizó la tinción sudan III y el reactivo de Saathoff, con lente microscópico de 40 y se tomaron en cuenta las gotas grandes y medianas de grasa por campo. Es una investigación clínica con enfoque epidemiológico, observacional de tipo aleatoria. Resultados. Del total de niños 53% fueron varones y 47% niñas. El promedio de evacuaciones por día fue de 3 en los recién nacidos, de 2 a 3 en los lactantes menores de 4 meses y de 1 a 2 en los de 5 a 12 meses de edad. El valor normal de la prueba Sudan III en heces varía dependiendo de la edad. En RN pre-término un promedio de 5.4 gotas (12-0 gotas)de grasa por campo, en RN a término 7.9 gotas ( 16-0), en lactantes menores de 4 meses de edad 4.3 gotas (10-0) y en los lactantes de 5-12 meses 3.8 gotas( 6-0) de grasa por campo. Conclusiones. La prueba Sudan III orienta en el diagnostico de esteatorrea en niños, en pacientes con mala absorción intestinal y en la evaluación del uso de enzimas pancreáticas. Es una técnica sencilla, económica y fácil de realizar. El conocer los valores normales dependiendo de la edad pediátrica permite al médico tratante plantear la existencia de esteatorrea patológica.

          Translated abstract

          Steatorrhea is the loss of fat through the stools. It becomes clinically apparent with the presence of increased amounts of foul and fatty stools. It can be determined through the Van de Kamer method, the acid steatocrit and the Sudan III stain test of stools. The objective of this paper is to specify the normal value of the Sudan III Stain Test of stools. Methods. 2000 healthy children stools samples were included. Age groups were preterm’s, newborns, and infants between 1-4 and 5-12 months of age. 500 samples were collected for every group. The study was performed at the Hospital Universitario de los Andes, in Mérida- Venezuela, during years 1999 through 2009. The Sudan III Stain Test and the Saathoff reactive were employed, as well as a high power objective lens. The number of large and medium fat drops by field was considered for the classification. This is a prospective, observational, randomized clinical trial. Results. For the total number of children (53% males and 47% females) the average of evacuations per day showed a total of 3 times in the newborns, from 2 to 3 times in the infants between 1-4 months of age and from 1 to 2 times in the infants between 5 and 12 months of age. The normal value of the Sudan III Stain Test of stools varies according to age: in preterm newborns this test shows an average of 5,4 drops (12-0) of fat per field, in full term newborns 7,9 drops (16-0), in infants from 0 to 4 months 4,3 drops (10-0) and in infants between 5 and 12 months 3,8 drops (6-0) of fat per field. Conclusion. Sudan III Stain Test guides in the diagnosis of steatorrhea in children, in patients with intestinal malabsorption syndrome and in the evaluation of the indication of pancreatic enzymes. This is a cheap, simple and easy technique .To know the normal values in the different pediatric age groups, allows to establish the presence of steatorrhea.

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          Parasites in patients with malabsorption syndrome: a clinical study in children and adults.

          Intestinal parasites not only cause diarrheal diseases but also significant malabsorption. Literature on the role of parasites, such as intestinal coccidia and microsporidia in malabsorption syndrome is limited. Three consecutive stool samples from 50 adult and 50 children patients with malabsorption syndrome and an equal number of healthy controls without diarrhea were examined for intestinal coccidia, microsporidia and other intestinal parasites by wet mount, Kinyoun's modified acid-fast staining and chromotrope 2R staining. Celiac disease was the commonest cause of malabsorption syndrome in both adults (52%) and children (74%). Forty (80%) and 41 (82%) adults and children, respectively, with malabsorption syndrome were infected with parasites. These results were significantly higher in comparison to those from the healthy adults and children controls (22% and 16%), respectively (P < 0.001). Of them, 48% and 46% of the adults and children, respectively, with malabsorption had pathogenic parasitic infections. The pathogenic parasites detected in adults were Giardia lamblia 12 (24%), E. histolytica / dispar 5 (10%), Ancylostoma duodenale 4 (8%), H. nana 2 (4%) and Cyclospora cayetanensis 1 (2%). The pathogenic parasites detected in children with malabsorption syndrome were Giardia lamblia 8 (16%), Cryptosporidium 7 (14%), E. histolytica / dispar 3 (6%), Ancylostoma duodenale 3 (6%), Isospora belli 1 (2%), and H. nana 1 (2%). None of the stool samples from healthy controls were positive for Cryptosporidium spp., Cyclospora and Isospora belli. All the patients infected with intestinal coccidia were HIV sero-negative. Celiac disease is the most common cause of malabsorption syndrome in both adults and children. These people harbor significantly more pathogenic parasites and are more frequently colonized with harmless commensals as compared to healthy controls. Intestinal coccidia are associated with malabsorption syndrome, particularly in malnourished children.
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            A new method of quantitative fecal fat microscopy and its correlation with chemically measured fecal fat output.

            Fecal fat microscopy using the Sudan stain has suffered from a relative lack of specificity, and results are "qualitative." Therefore, we developed a quantitative fecal fat microscopic method with hopes of improving diagnostic accuracy. One hundred eighty patients with chronic diarrhea collected stools for 1 to 3 days, and fecal fat output was measured by a standard chemical method, and microscopy was performed by the old qualitative and new quantitative methods. There was a highly statistically significant linear correlation between quantitative fecal fat microscopy and chemically measured fecal fat output. The quantitative microscopic method had a sensitivity of 94% and a specificity of 95%; the traditional method had a sensitivity and specificity of 76% and 99%, respectively. Fecal fat Sudan microscopy performed by a dedicated approach to counting and size measurement of fat globules can yield a quantitative result that correlates well with chemically measured fecal fat output and has a high diagnostic accuracy.
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              Pediatric celiac disease.

              Celiac disease is an extremely common, although underdiagnosed, disorder. Knowledge about the varied clinical manifestations and the proper approach to screening and diagnosing celiac disease will lead to appropriate early intervention in affected children New age-dependent algorithms are emerging to properly screen for celiac disease. There is new evidence on the patchy nature of celiac disease supporting the practice of multiple duodenal biopsies including the bulb of the duodenum. Therapeutic dietary compliance, particularly in asymptomatic children, can be poor, and therefore, the involvement of a dietician trained in celiac disease is instrumental in keeping patients up to date with dietary guidelines and to improve their compliance to the diet. Expanding knowledge about the pathogenesis of celiac disease has led to the development of investigational therapeutic alternatives to the gluten-free diet. Ongoing clinical trials are evaluating methods of celiac disease prevention in at-risk infants. This review aims at outlining the different manifestations of celiac disease in children as well as a step-wise approach to screen and diagnose the disease. A better understanding of the pathogenic mechanisms of celiac disease is paving the way to innovative diagnostic tools, preventive strategies, and therapeutic interventions alternative to a gluten-free diet.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                avpp
                Archivos Venezolanos de Puericultura y Pediatría
                Arch Venez Puer Ped
                Sociedad Venezolana de Puericultura y Pediatría (Caracas )
                0004-0649
                March 2012
                : 75
                : 1
                : 16-19
                Affiliations
                [1 ] Universidad de los Andes (ULA) Venezuela
                [2 ] Hospital Universitario de los Andes Venezuela
                [3 ] HULA Venezuela
                [4 ] ULA Venezuela
                Article
                S0004-06492012000100005
                f9d23338-1cef-4ccc-ae52-dda365c32c2e

                http://creativecommons.org/licenses/by/4.0/

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                Product

                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0004-0649&lng=en
                Categories
                HEALTH CARE SCIENCES & SERVICES
                HEALTH POLICY & SERVICES
                PEDIATRICS

                Pediatrics,Health & Social care,Public health
                esteatorrea,prueba Sudan III en heces
                Pediatrics, Health & Social care, Public health
                esteatorrea, prueba Sudan III en heces

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