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The maternal suckling is very important in the alimentation of the children and his effect in the hematopoietic system is not clear. Were studied the hematology children between three and six month, in the external consultation of Hospital Universitario Dr. Angel Larralde, since July 1990 to November 1992. 50 patients received exclusive maternal suckling and 10 artificial. The age and the sex in the three groups were homogeneous. The values of hemoglobin was greater in the exclusive maternal suckling group, with a 72% of the patient with values between 10.2 and 11.9 gr. Was not significative difference in the account leucocyte. The polymorphonuclear percentage was less in the exclusive maternal suckling group with values between 20 and 34% in the 84% of the cases. The lymphocyte account was greater in this same group, with the 92% of the patients with values between 60 and 74%. We conclude that the different king of suckling affect in important form the hematology values in the first six month of the live.

The association between chronic liver disease and plasmatic lipids and glucidic metabolism was studied. The liver was evaluated with biochemical variables, ultrasound and upper gastrointestinal endoscopy. 12 chronic liver diseases patients and 10 normal were studied. 83.3% of patients showed lipidic abnormalities, 66.6% on the cholesterol levels and 41.7%, reduced HDL. When patients received 100 gr of glucose the response was abnormal in 83.3%. These results were compared with other "liver function test". 75% had abnormal bilirubin, 58.3% abnormal albumin, prothrombin time 58.3%, aminotransferases 75%. Esophageal verices were found in 75% of cases and ultrasound abnormalities in 91.6% (27.3% cirrhosis, 54.4% diffuse abnormal patter and 18.2% splenomegaly). These findings show that lipidic and glucidic metabolism, and ultrasound, in chronic liver diseases are the more frequent abnormalities.

In this article the current concepts on persistent diarrhoea are reviewed. Persistent diarrhoea is important because its aetiology is unclear, is difficult to treat, affects the nutritional status and increases the risk of death. The identification of risk factors for persistent diarrhoea is important because it can obtain valuable information relative to the pathogenesis and prevention of this disease. The concepts of diarrhoea and risk factors are also reviewed. In addition we explore the methods of management and treatment of patients with persistent diarrhoea.

We describe the isolation and axenization of two E. histolytica strains, obtained from the stools of two patients with the clinical diagnosis of dysentery. We used Pavlova's medium for initial polixenic culture, and TYI-S-33 (Diamond's) medium for monoxenic and axenic cultures. In order to eliminate the microorganism contaminating the stools the following antibiotics were used: penicillin, streptomycin, ampicillin, chloramphenicol, kanamycin, nistatin, ceftriaxone and amphoterycin B. Both strains grew in similar culture conditions with a yield of 2 x 10(6) microorganism per tube of 15 ml. Both strains belong to pathogenic zymodemes, and virulence was determined by the capacity for producing hepatic abscesses in 100% of the hamsters inoculated intrahepatically.

The value of aflatoxins is well known as a carcinogenic, mutagenic and teratogenic, likewise its association with the hepatitis B virus. In addition, it is known the incidence of hepatocellular carcinoma in such viral infection. A study was performed on the albumin adducts-aflatoxins levels in sera determined by ELISA method of children within 3-15 years old at the Service of Pediatric Gastroenterology from the National Institute of Gastroenterology. Samples consisted of 40 patients with chronic active hepatitis (CAH) B, 10 HBsAg+ carriers and 20 controls. The CAH group, showed a 32.5% of positiveness with a maximum levels of 25pg aflatoxin lysine/mg albumin while 20% of HBsAg positive carriers showed levels of un 12.3 pg aflatoxin lysine/mg albumin and 15% of the control group 5pg AF lysine/mg albumin. It can be observed that aflatoxin levels in patients of CAH presented values up to 5 times over the control group. This study suggest the validity of aflatoxin-albumin adducts as a marker of chronic exposure to this carcinogen and its importance in relation with the virus of hepatitis B.

Acetaminophen high doses toxicity has been reported in clinical and experimental studies in relation with cytochrome P-450. (Acetaminophen metabolite). Thinking that biliary tract obstructions hould increases drugs toxicity because interferes toxic substances excretion or it modify the activity of P-450 we decided to study acetaminophen toxicity in rats with biliary tract obstruction. Male sprague Dawley rats were used (body weight 250-400 gr) in two groups: Group I control (6 rats) with choledoco bile duct ligated; two doses of saline solution 0.9% Intraperitoneal, 0.2 ml/100 gr. were administrated. Group II (Same surgical intervention) received two doses of acetaminophen (intraperitoneal) solution (400 mg/Kg). This group was divided in two (6 rats each), one of this was sacrificed at 48 h. and the other one at 120 h. after acetaminophen injection. Total, direct and indirect bilirubin, alkaline phosphatase, ALT and AST transaminases, hematology study, liver weight, histological studies of liver and kidney were performed in all rats. High incidence of liver necrosis ans significative transaminases increases were found in group II. Our results were discussed taking account that recent biliary tract obstruction increase acetaminophen toxicity, at a half doses reported in other studies. It is possible that mixed oxidation system activity of cytochrome P-450 was increased in our research.

Intestinal Metaplasia (IM) and Helicobacter Pylori (HP) infection had been related to gastric carcinogenesis. With the intention to know the relationship among HP infection, IM and inflammatory response of the mucosa in an area of high prevalence of gastric cancer, we studied 800 persons that attended the Gastric Cancer Mass Survey, ongoing in the State Tachira, Venezuela, since 1981. Out of these subjects, 259 had histology diagnosis of IM (32.4%) 52.1% were IM type Y, 19.3% type II and 22.8% type III (sulfomucin secretory). Histology demonstrated with Giemsa stain HP in 94.6% of the cases. Association between HP and inflammation response in gastric mucosa with IM, was statistically significant (p = 0.001). The are heavier bacteria overload in IM type I than in type III although it is not statistically significant. We ponder if gastric mucosa inflammation due to HP, conditions development of IM as a hostile way of the gastric environment to restrain bacterial growth. This phenomenon ally with other oncogeneous factors could induce to premalignant lesions and eventually gastric cancer.

The evaluation of early gastric cancer in the Central Hospital of IVSS "Miguel Pérez Carreño" of the urban area shows a detectability rate of 5.03% from gastric carcinoma total cases. Depressed macroscopic type and differentiate microscopic type are the most frequent. Predominant location is antrum. Early Gastric Cancer with elevated component, differentiate papillar type, submucosal invasion and with positive lymph node must be operated with very carefully and systematic lymph node dissection, depending on the location and the size of the primary tumor, and also post-operative adjuvant chemotherapy is likely to be necessary as well, to achieve diminishing the recurrence and mortality rates. Its our duty look for a better team work and methodology in the detection of early gastric cancer to obtain more superficial and smaller lesions. So there fore another therapeutical alternatives such as Endoscopical Mucosal Resection and Laparoscopic Wedge Resection could take a place in the future.

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 dilation with Savary Gilliard bougie. The dilatation 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 posteaustic group 385 dilatations were performed in 115 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. Oesophageal dilatation with Savary-Gilliary bougies represents a safe and reliable method for the treatment of esophageal strictures.