ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Anti-endoplasmic reticulum antibody positive autoimmune hepatitis in children is characterized by the recognition of a single 50,000 MW protein of the endoplasmic reticulum in liver microsomal fractions by their sera. We have developed an enzyme-linked immunosorbent assay technique with rat liver microsomal preparations as the antigen to be used for detection of this disease, liters obtained may be useful in following the course of the disease and as an aid in determining when therapy can be discontinued. The technique is rapid, sensitive, reproducible, and simple to perform and is easier to manipulate than immunofluorescence or radioimmunoassay techniques.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The pharmacokinetics and pharmacodynamics of metoclopramide oral solution were evaluated in six infants (0.9–5.4 months) with gastroesophageal reflux (GER) following the initial and 10th dose of 0.15 mg/kg administered every 6 h. Metoclopramide pharmacodynamics were assessed by pre- and post-dose comparison of esophageal pH monitoring data and clinical evaluation of improvement in GER symptoms. A significant reduction in the number of episodes of pH <4 for greater than 5 min and the longest episode of GER was seen between the predose and 10th dose (steady-state) evaluation periods. Four of the 6 patients had a 75% reduction in reflux time and demonstrated improvement in clinical symptoms by the 10th dose. Metoclopramide pharmacokinetics were best characterized by a one-compartment open model following the first and 10th doses. Metoclopramide serum concentrations (mean ± SD) ranged from 56.2 ± 23.5 to 32.7 ± 13.2 ng/ml within a 6-h dosing interval at steady state. There were no significant differences between the first versus tenth dose values forTmax(2.0 ± 0.5 versus 2.2 ± 0.4 h),Kel(0.14 ± 0.03 versus 0.17 ± 0.04 h−1),Vdarea, (4.9 ± 0.4 versus 4.4 ± 0.6 L/kg), or clearance (0.66 ± 0.16 versus 0.67 ± 0.13 L/h/kg). The youngest subject (3.5 weeks) had a metoclopramide t1/2, of 23.1 h following initial dose, which decreased to 10.3 h at steady-state. Care should be exercised in using the 0.15 mg/kg dose in infants less than 1 month of age as prolonged clearance may produce excessive serum concentrations.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

We investigated the mechanisms of gastroesophageal reflux (GER) and esophageal motility during endogenous esophageal acid exposure in 17 patients with reflux disease alone (age range 3–20 months) (group A) and in 10 patients with reflux disease complicated by esophagitis (age range 4–19 months) (group B), by simultaneous recording distal esophageal sphincter relaxation was the predominant mechanism of reflux in both groups of subjects; however, it was more frequent in group B patients (Bpts), whereas reflux episodes due to appropriate sphincter relaxation were delected more frequently in group A patients (Apts). During endogenous acid exposure, primary peristalsis was the most frequent esophageal motor event in all patients; furthermore, its amplitude was significantly higher in Apts as compared with Bpts. Primary peristalsis was more efficacious (rise of intraluminal pH by at least 0.5 unit) in patients with reflux disease alone, whereas nonspecific motor irregularities were more common in children with reflux esophagitis. It is concluded that the major mechanism of GER in patients with reflux esophagitis is an inappropriate sphincter relaxation; reflux due to appropriate sphincter relaxation is associated with less severe reflux disease; and patients with esophagitis exhibit a deranged esophageal motility during spontaneous acid exposure.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Some authors recommend a routine “protective” antireflux procedure (ARP) in neurologically impaired children undergoing feeding gastrostomy (FG). Over 4 years, we performed FG in 107 neurologically impaired children aged 1 month to 16 years. Ninety-eight had preoperative radiological assessment for gastroesophageal reflux (GER), which was documented in 44, of whom 33 had FG plus ARP and II had FG alone. Seven of the 11 subsequently developed symptomatic GER and 5 of them had a secondary ARP. Of the 54 children with no demonstrable GER preoperatively. 3 children underwent FG plus ARP. The remaining 51 had FG alone. There was one postoperative death. Of the 50 surviving patients. 22 developed symptomatic GER and 17 of these had a subsequent ARP. Mean follow-up of 20.0 months showed that the risk of developing GER after FG alone was not influenced by age, sex, indication for FG, underlying diagnosis, or method of gastrostomy. There was no significant difference in mortality and early morbidity between patients undergoing FG alone and those having FG with simultaneous or subsequent ARP. Only 44% of our patients in whom GER was not demonstrated initially developed symptomatic GER followed FG alone. This incidence does not justify a routine “protective” ARP.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

After the administration of a 59% glucose-water solution that contained tracer amounts of the stable non-radioactive isotope13C, breath samples were collected from five children with congenital glucose-galactose malabsorption and five with severe small bowel villous atrophy and chronic diarrhea. The13CO2, breath test curves of the children with the congenital malabsorption and chronic diarrhea were compared with each other and with those from three healthy children and four infants with severe malnutrition but no diarrhea. The breath test curves from the children with glucose-galactose malabsorption and from those with diarrhea were significantly different from those of the other two groups, a finding consistent with impairment of glucose absorption. The [13C]glucose breath test clearly identified the children with severe glucose malabsorption. Further studies are required to determine whether less severe cases of carbohydrate malabsorption also can be identified using the parameters described in our study.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The malabsorption of a physiological dose of lactose (0.5 g/kg body weight) was studied in 726 healthy Chinese children, ranging in age from 3 to 18 years, using the breath hydrogen test. The prevalence of lactose malabsorption was found to increase with age: it occurred in <15% of preschool-age children and in — 45% of younger school-age and 60% of older school-age children. Approximately 70% of adolescents measured showed malabsorption. The critical period of change was from 6 to 7 years of age. with the lactose malabsorption rate rising abruptly from 12 to 43%. The incidence of lactose intolerance in teenagers and adolescents was 27 and 33%, respectively. The great majority of them had only dull abdominal pain. No case of lactose intolerance was seen in children <9 years of age. These results indicated that preschool Chinese children can absorb a physiological dose of lactose (equivalent to the average amount of milk consumed daily) without any adverse effects. In contrast, one half of school-age children and two thirds of adolescents were malahsorbers.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

The role of lactose malabsorption (LM) was investigated in 32 children (mean age 8.13 ± 2.46 years) with recurrent abdominal pain (RAP). LM was detected in 75% of them by a lactose breath hydrogen test (LBHT) after a 2-g/kg (max 50-g) load. Of the 18 malabsorbers who participated in a 3-month lactose-free diet (LFD), 14 were judged “improved” and reported lower pain frequency (p < 0.001). The malabsorbers who improved versus the not improved had comparable past lactose ingestion but were distinguishable on the basis of their lactose absorption capacity (0.36 vs. 0.81 g/kg; p < 0.01), as subsequently determined by multiple LBHTs with 25-, 12.5-, and 6-g loads. The ratio between past lactose ingestion and lactose absorption was 1.89 in the improved and 0.55 in the not improved groups (p < 0.01), retrospectively indicating lactose as a possible cause of the symptoms in the improved group. The reintroduction of lactose in amounts not exceeding the absorption capacity into the diet of each malabsorber who had improved with LFD caused relapse in none of the 14 subjects monitored for 2–6 months. In conclusion, LM seems an important cause of symptoms in Italian children with RAP. Assessment of the lactose absorption threshold of each subject of LBHTs provides a basis for reintroduction of “calibrated” amounts of lactose-containing foods (e.g., milk) into the diet.

ISSN:0277-2116    

出版商:OVID    

年代:1988

数据来源: OVID