摘要:

BackgroundBreast-fed infants grow more slowly than bottle-fed infants. This growth deceleration sometimes alarms health care personnel to the point of considering other forms of nutrition.ObjectivesTo evaluate the final adult anthropometric outcome associated with breast or formula feeding during infancy.DesignHeight and weight data were collected from eight well-baby clinics representing various ethnic origins, lifestyles, and socioeconomic backgrounds. Children were measured every 1 to 2 months for the first 6 months, every 3 months until 2 years of age, and yearly thereafter, until they reached their final height. Longitudinal data were collected from 1960 healthy children (961 boys). Overall, 613 of the children were breast fed for 1 year and 218 for 6 months.ResultsThe magnitude of the decline in Z scores of breast-fed vs. bottle-fed infants, between birth and 1 year of age was not as great for height as for weight −0.2 and −0.3 respectively, and disappeared at 2 years of age. The weight for height decreased between birth and the end of the first year in breast-fed children by 0.3 (Z score). Children switched to bottle feeding exhibited a growth spurt. However, there was no difference in the final heights or weights of breast-fed children compared with bottle-fed children 165.3 ± 6.2 (n = 134) versus 164.9 ± 6.4 (n = 195) in females, respectively, and 175.3 ± 6.8 (n = 122) versus 175.8 ± 7.1 (n = 162) in males, respectively. Adult obesity in this sample population (n = 637) was correlated with maternal obesity. Maternal BMI SD correlated with offspring BMI SD at 18 years of age (r = 0.873,P< 0.001) but not with breast feeding. Adult BMI was similar between the breast-fed and bottle-fed groups.ConclusionsDespite their slower growth rate, breast-fed children reach the same final height as bottle-fed children. Breast-fed infants should be monitored according to specifically designed growth charts. Obesity in adult life is correlated with factors not related to breast feeding.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundCalprotectin is a protein abundant in neutrophils. Fecal calprotectin can be used as a marker of gastrointestinal inflammation, and an improved assay has recently been developed. The aim of this study was to establish reference values for fecal calprotectin in healthy children aged between 4 and 17 years.MethodsFecal samples were obtained from 117 healthy children classified into four age groups: 4 to 6 years, 7 to 10 years, 11 to 14 years, and 15 to 17 years. A health questionnaire was used to ensure that these children fulfilled the inclusion criterion and did not have intercurrent disease, nasal or menstrual bleeding, or nonsteroidal anti-inflammatory drug medication before the sampling period. Calprotectin was analyzed using a quantitative enzyme-linked immunosorbent assay (Calprest, Eurospital SpA, Trieste, Italy). Children with fecal calprotectin values >50 &mgr;g/g were asked to deliver an additional sample.ResultsThe overall median fecal calprotectin concentration was 13.6 &mgr;g/g (95% confidence interval, 9.9–19.5 &mgr;g/g) in the 117 children. In the different age groups, 4 to 6 years, 7 to 10 years, 11 to 14 years, and 15 to 17 years, the median calprotectin concentrations were 28.2, 13.5, 9.9, and 14.6 &mgr;g/g, respectively. Of these children, 104 (89%) had a concentration <50 &mgr;g/g. The remaining 13 children with a calprotectin concentration >50 &mgr;g/g delivered one additional fecal sample. All showed a lower concentration in the second sample except for one teenager who later proved to have proctitis.ConclusionsThe suggested cutoff level for adults (<50 &mgr;g/g) can be used for children aged from 4 to 17 years regardless of sex. A fecal calprotectin concentration >50 &mgr;g/g warrants follow-up.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectivesDescribe outcomes in nine children with Nissen fundoplication and feeding gastrostomy treated in a multicomponent feeding program. The importance of comprehensive evaluation, appetite regulation, and family-focused intervention within a behavioral feeding program are discussed.MethodsProspective clinical intervention with dependent measures evaluated before treatment, after treatment, and at follow-up.ResultsNine children (4 girls; mean age, 3.1 ± 1.2 years; range, 1.8–5.5 years) and their mothers were admitted for intensive treatment (mean duration, 11.4 ± 1.7 days; range, 5–16 days). At discharge, 4 of 9 (44%) children were weaned completely from gastrostomy feedings. The mean oral intake of all patients increased 50% from pretreatment to posttreatment assessment. At a mean of 3.1 ± 0.5 months (range, 2.4–3.6 months) after treatment, six of nine children were weaned completely from gastrostomy feedings. The percent of daily nutritional needs consumed orally increased from a pretreatment mean of 14.6% ± 21.2% (range, 0%–67%) to a posttreatment mean of 63.4% ± 18.3% (range, 34%–85%) and a follow-up mean of 88.1% ± 25.1% (range, 30%–100%). The mean percent ideal body weight for height was not compromised during intensive treatment.ConclusionsShort-term intensive biobehavioral treatment was successful in improving oral intake and weaning from gastrostomy tube feeding in children with Nissen fundoplication and feeding gastrostomy.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundAlthough a dextran sodium sulfate (DSS)-induced colitis is commonly used as an ulcerative colitis (UC) model in adult rodents, there are no studies using this model in young animals. We examined differences in the severity of DSS-induced colitis as a function of the concentration of DSS administered and sought to establish a DSS-induced colitis model in young rats.MethodsWe administrated different concentrations of DSS solution (2%, 3%, and 4%) to 4-week-old weanling rats and compared their clinical findings, colonic histologic findings, mucosal leukotriene B4(LTB4) production, and mucosal blood flow with control weanling rats and 8-week-old adult rats given 4% DSS for induced colitis.ResultsClinical symptoms, such as diarrhea and rectal bleeding, histologic findings, and disturbance of mucosal microcirculation in weanling rats given 4% DSS were significantly more severe than those in adult rats given the same treatment. Three of 10 rats given 2% DSS had no bloody stool and 2 of 10 rats given 4% DSS died during the experimental periods. Clinical symptoms, hemoglobin levels, histologic damage scores, mucosal LTB4production, and mucosal blood flow became more severely deranged as the concentration of DSS increased from 2% to 4%.ConclusionThese findings suggest that we can adjust disease severity in UC model for young children by giving different concentrations of DSS to weanling rats.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

BackgroundThe majority of cases of failure to thrive (FTT) are non-organic. Many of these patients present with significant decreased caloric intake. It appears as if the appetite regulation center in the hypothalamus is not attuned to the calorie requirements of the infant.ObjectiveOur hypothesis was that some cases of non-organic FTT might be caused by abnormalities in hunger/satiety control secondary to neuroendocrine or cytokine imbalance. The aim of this study was to investigate which hormonal/cytokine profiles could be assigned to a defined category of FTT, namely organic, psychosocial and idiopathic subgroups.Study design34 patients were enrolled and 32 completed the study (12 controls, 12 idiopathic FTT, 5 organic FTT, and 3 psychosocial FTT). Each child was assessed by a pediatric gastroenterologist, dietician, and social worker and underwent appropriate laboratory investigation during which leptin, IL1, IL6 and TNF-&agr; levels were determined. The Mann-WhitneyUtest was used to compare the groups.ResultsIL6 was the only cytokine that showed significant differences between FTT patients (4.06 ± 6.3 pg/ml) and normal controls (0.0 pg/ml (p = 0.028). Leptin values were significantly higher in the normal control group (1632 ± 483 pg/ml) as compared to FTT patients (685 ± 687 pg/ml) (p = 0.001).ConclusionsOur results indicate that leptin does not play a role in the pathogenesis of anorexia in children with FTT. It is however, possible that IL6 may be an important factor in the etiology of anorexia in patients with FTT.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectivesCrohn disease is a chronic inflammatory bowel disorder that is caused by environmental and genetic factors. Mutations in theCARD15gene have been recently identified to be associated with the disease. Until now no genetic study has focused directly on a pediatric population.MethodsThe authors sequenced all 12 exons of theCARD15gene in 55 pediatric patients with Crohn disease from Saxony. Their average age at onset was 11.2 years (1–17.5 years). The authors also evaluated the genotype-phenotype relationship in the patients.ResultsFourteen different polymorphic and/or disease-related nucleotide alterations have been identified in the patients. Sixty-five percent of their genomic DNA samples harbored at least one of six mutations within theCARD15gene, which previously has been identified as being associated with Crohn disease. The authors found that the cytosine insertion mutation 3020insC was significantly more common in their pediatric population than in patients with Crohn disease (26% versus 11% of the alleles) whose results were reported in the literature. The genotype–phenotype analysis showed that the authors' patients with at least one of the sixCARD15disease-associated mutations had a high risk of inflammation located in the terminal ileum and ascending colon. In 10 of 19 patients with two mutations, intestinal resection surgery was necessary because of stricturing.ConclusionsIn the authors' pediatric patients, the genetic influence on Crohn disease was more pronounced than that reported in any other study, and it strongly affected the clinical phenotype.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

ObjectivesChildren occasionally have dysphagia in the absence of an apparent primary cause. Esophageal eosinophilia is sometimes seen in these patients at the time of upper endoscopy but its significance is not clear. Although eosinophilia is regarded by some as a histologic hallmark of childhood reflux esophagitis, it may in fact signal a primary eosinophilic esophagitis in children with dysphagia. Our aim was to evaluate esophagitis, acid reflux determined by pH probe, and esophageal eosinophilia in children with the primary complaint of dysphagia.MethodsA retrospective study was performed in 42 children, admitted for investigation of dysphagia, in whom no primary cause could be found. Twenty-one children (mean age ± SD, 10.1 ± 4.0 years) had esophageal eosinophilia and 21 children (8.3 ± 4.7 years) did not. Clinical, endoscopic, manometric and esophageal pH parameters in these two groups were compared.ResultsPatients with esophageal eosinophilia were more often male (p<0.01) with a history of allergy (p<0.001) and food bolus obstruction (p<0.05) requiring endoscopic removal. Their esophageal mucosa appeared wrinkled and thickened at endoscopy with basal cell proliferation, and large numbers of eosinophils in esophageal mucosal biopsies. Continuous esophageal pH records and motility studies, when obtained, were similar in both groups and were within normal values.ConclusionChildren with dysphagia who have esophageal eosinophilia are unlikely to have pathologic gastroesophageal reflux.

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:2003

数据来源: OVID