ISSN:0277-2116    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Ten healthy preterm infants were studied to determine if non-nutritive and nutritive suck significantly altered gastric emptying patterns when compared with gav-age feeding alone. We used a 10% dextrose meal with phenol red marker and a double sampling technique to determine gastric emptying at 10-min intervals over a 30-min test period. A crossover study design compared the effects of the three feeding methods in each infant. The gastric residual volumes expressed in milliliters per kilogram did not differ significantly when comparisons were made among groups at 10, 20, and 30 min following the test meal. Non-nutritive suck and nutritive suck and swallow of a liquid dextrose meal do not significantly improve gastric emptying in healthy preterm infants. The beneficial effects of non-nutritive and nutritive sucking on the nutritional status of preterm infants, demonstrated by others, are not related to improved gastric evacuation of feeds. Alternative explanations for these beneficial effects require further investigation.

ISSN:0277-2116    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Gastric pH was recorded with an intragastric pH electrode for 12 h in two groups of healthy, preterm infants with similar birth weights (range 1.4 to 2.0 kg). Group I infants (n = 13) were less than 7 days old and Group II infants (n = 10) were 7–15 days old. Infants were fed three formula feedings and one clear liquid feeding during the study. In Group I, mean gastric pH measured at 15-min intervals was above 4.0 for 3 h after either feeding. In Group II mean gastric pH was lower particularly after clear liquid feedings, where it remained below pH 4.0 for the entire 3-h postprandial period. The percent of monitored time at gastric pH less than 4.0 was low in Group 1–15.2 ± 4.2% and 20.6 ± 6.4% after formula and clear liquid, respectively. The percent time was greater in Group II-42.7 ± 8.0% and 61.9 ± 7.3% after formula and clear liquid, respectively. In the younger preterm infant, gastric pH does not appear sufficiently low to support peptic activity.

ISSN:0277-2116    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Esophageal pH monitoring has been performed in 60 asymptomatic neonates between 1 and 10 days old. Several parameters (periods with a pH <4, number of reflux episodes, number of reflux episodes lasting more than 5 min, average duration of the longest reflux episode, average pH) were studied in different positions (in prone and supine position, in right and left side lying position). For all parameters, except for the average pH, we obtained significantly more favorable results in prone position. In 22 vomiting neonates, significantly favorable results were obtained only by application of positional therapy: in prone position with head elevated (anti-Trendelenburg). There was no significant difference between the symptomatic group (with radiologically proven reflux pathology) in prone and anti-Trendelenburg position, and the control group in prone horizontal position. The 17-h continuous pH monitoring in the newborn is a nonaggressive investigation technique in physiological circumstances, which adequately completes and/or replaces the traditional examinations on gastroesophageal reflux. This method enables an evaluation of the favorable effect of simple therapeutic means (positional changes). Medication, and thickening and staggering of feeding (a time-consuming and tiring burden for the parents), can be avoided with this technique

ISSN:0277-2116    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Aspirin reduced plasma concentrations of prostaglandin (PG) Fα in 11 of 12 children with toddler diarrhoea, and usually, but not always, controlled the symptom. Loperamide consistently controlled toddler diarrhoea in 10 patients but had no effect on plasma PGFα. In eight patients experiencing spontaneous remission of symptoms, plasma PGFα was significantly lower than during diarrhoeal episodes. These results suggest that (a) toddler diarrhoea is in some cases mediated by PG, and (b) the effect of loperamide is independent of PG levels.

ISSN:0277-2116    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Different combinations of fluid therapy, feeding regimen, and cholestyramine were compared in search for optimal treatment of infants hospitalized for acute diarrhea. The infants (n = 81) received either rapid oral rehydration using the oral rehydration solution-World Health Organization formula (sodium 90 mmol/L, ORS-WHO) or traditional oral fluid replacement using a commercial glucose-electrolyte solution (sodium 35 mmol/L). One-half of the infants in both groups received full feedings at 24 h of hospitalization; in the remaining infants, feedings were gradually introduced over a period of 5 days. In addition, all the children were randomized to receive either cholestyramine 2 g four times daily or an equivalent amount of placebo. Rehydration with ORS-WHO, but not traditional fluid replacement therapy, led to correction of initial metabolic acidosis after 6–10 h; no cases of hypernatremia were observed with the use of ORS-WHO. Rapid return to full feedings appropriate for age, including milk products, was associated with better weight gain and significantly shorter duration of diarrhea compared with gradual introduction of feedings. Cholestyramine treatment further shortened the duration of diarrhea without adverse effects in those children who had received ORS-WHO and thus were properly rehydrated. In contrast, in children with poor initial hydration, cholestyramine treatment was associated with prolonged metabolic acidosis. We conclude that treatment of acute diarrhea by rehydration with ORS-WHO and rapid introduction of full feedings is effective and safe, and this combination forms a therapy of choice for typical hospitalized cases of acute infantile diarrhea in Finland. Cholestyramine may be of value as an adjunct therapy after adequate rehydration.

ISSN:0277-2116    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Evidence for autoimmunity in diarrhoeal disease is reviewed. Firstly, coeliac disease (CD) is considered. The incidence of tissue-reactive autoantibodies in both adults and children with CD (68% and 65%, respectively) is higher than the incidence of these autoantibodies in controls (6% in normal adults, and 14% and 9% in disease controls drawn respectively from adult and child populations). TheRran-tireticulin antibody, when present, was found to disappear after several weeks on a gluten-free diet, but in contrast, other autoantibodies persisted. Secondly, a case is argued for a new disease category, namely “autoimmune enteropathy.” Seven cases are reviewed in which patients presented with protracted diarrhoea, a small intestinal enteropathy which failed to heal during periods of total parenteral nutrition, and evidence of a predisposition to autoimmunity (namely, the presence of high titre autoantibodies including one specific for gut epithelium, and/or the presence of associated diseases regarded to be autoimmune). Thirdly, evidence for autoimmunity in inflammatory bowel disease is reviewed and includes discussion of serum goblet cell antibodies and of circulating T cells which participate in antibody-dependent cellular cytotoxicity in vitro using colonic epithelial cells as targets. Finally, an unusual child is described who presented with chronic diarrhoea and a flat small intestinal mucosa, who responded to gluten withdrawal but who later relapsed spontaneously during a strict gluten-free diet. Her mucosa healed only after a period of total parenteral nutrition and treatment with oral steroids. This child'S enteropathy was also associated with thyrotoxicosis and a microscopic colitis.

ISSN:0277-2116    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Breath hydrogen tests were carried out on 157 children either because they had chronic diarrhea or because they were on disaccharide-free diets. Lactose malabsorption was common in patients with postgastroenteritis syndrome (43%), and sucrose malabsorption was readily detected in patients with congenital sucrase-isomaltase deficiency. Secondary sucrose malabsorption and small bowel bacterial overgrowth were also detected. In predicting clinical response to dietary change, the breath hydrogen test, as we perform it, was clearly the most specific and sensitive and had a predictive accuracy of 96%. Duodenal biopsy results mobtained from 48 of the children gave a 23% incidence of misleading disaccharidase results (16.7% falsely normal, 6.3% falsely abnormal), but biopsy remains vital in the diagnosis of congenital sucrase-isomaltase deficiency. False negative breath hydrogen results were obtained on occasions (4%) but in most instances were related to recent antimicrobial therapy or failure of the breath test mechanics (e.g., vomiting, length of sampling).

ISSN:0277-2116    

出版商:OVID    

年代:1985

数据来源: OVID