摘要:

SummaryIn this article, the Working Group on Gastro-Oesophageal Reflux of the European Society of Paediatric Gastroenterology and Nutrition presents and discusses a definition of reflux esophagitis and recommends a diagnostic approach and therapeutic management for this condition. Histologic criteria for reflux esophagitis, modified and adapted to the particular needs of infants and children, are suggested. Upper gastrointestinal en-doscopy is recommended as the technique of choice in infants and children presenting with symptoms suggestive of reflux esophagitis. Prokinetics, although still a relatively new drug family, have already established a definitive place in the treatment of gastroesophageal reflux disease in infants and children and could also be used in the treatment of nonulcerative esophagitis, as suggested in the literature. If the esophagitis is more severe (ulcerative), treatment should initially consist of H2blockers and then be continued with prokinetics. New drugs, such as omeprazole, are suggested in cases refractory to H2blockers. Surgery is indicated in life-threatening conditions or if the esophagitis is resistant to adequate medical management.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SummaryMalnutrition and growth failure are frequent clinical consequences of human immunodeficiency virus (HIV) infection in children. Tube feeding is a means by which to increase the enteral intake of nutrients. We examined the effect of tube feeding in 18 children, median age 6 months (range, 3–159). Tube feedings were initiated due to growth failure in all, which was also associated with dysfunctional swallowing or aspiration in seven children and gastroesophageal reflux in two. Tube feedings were infused via nasogastric tube (n = 4) or gastrostomy tube (n = 14) and were continued for a median of 8.5 months (range, 2–24). Stoma complications developed in three children with gastrostomy tubes; these were the only tube-related side effect. Tube feedings were discontinued due to noncompliance (n = 3), gastrostomy leakage (n = 2), intolerance (n = 2), and death (n = 3). Anthropometric changes were evaluated comparing mean standard deviation scores (Z) before and after tube feeding. Tube feeding resulted in significantly increased weight for age (Z, −2.13 + 0.7 vs. −1.46 + 1.4; p = 0.04), weight for height (Z, −1.07 + 1.0 vs. −0.13 + 1.0; p = 0.004), and arm fat area (Z, −1.75 + 1.3 vs. −0.62 + 1.2; p = 0.01). However, tube feeding did not result in significant changes in height for age (Z, −1.93 + 0.8 vs. −1.74 + 1.6) or arm muscle area (Z, −1.24 + 0.9 vs. −0.57 + 1.2). Tube feedings effectively increased the weight of HIV-infected children in this study, but they were not sufficient to correct linear growth deficits.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SummaryThe percentages of γδ T cell receptor-bearing (TCR+) cells in the peripheral blood and jejunal mucosa of patients with celiac disease were measured before treatment, during a gluten free-diet, and after a gluten challenge. The percentages of the different cell types were evaluated by flow cytometry, and immunohistochemical staining of the jejunal specimen was used to identify lymphocyte surface markers. Nineteen blood samples and intestinal specimens from 13 children with celiac disease (eight samples taken before treatment, six during gluten-free diet, and five after gluten challenge) and samples from nine controls were studied. The proportion of γδ TCR+lymphocytes was significantly higher both in the peripheral blood and the jejunal mucosa of the patients with celiac disease. A significant correlation was found between the percentage of peripheral γδ TCR+cells and the density of γδ TCR+cells in the lamina propria.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SummaryBone density is related to body size and other factors including dietary calcium intake. The purpose of this study was to determine the effect of a low-lactose, low-calcium diet on the bone mineral content (BMC) of prepubertal children with documented lactose intolerance. Radial BMC was determined by single-photon absorptiometry. Dietary intake was assessed by 24-h recall and two 3-day food records, and weight and height were measured. The group of lactose-intolerant children was compared with a group of healthy children of similar age, gender, race, and size and to the prediction equations based on body size from Chan's Utah children. Nineteen children, ages 9.6 + 1.9 years, participated in the study. They were relatively short compared with standards (height Z score, −0.30 + 0.83). BMC was 0.428 + 0.081 g/cm in the study group versus 0.440 + 0.116 g/cm in the comparison group (n = 19; p > 0.05). Both the study group and the size-selected comparison group had lower BMC than the Utah children. The diet of the study group was low in calcium: 84% of the Recommended Dietary Allowance in children < 11 years old and 32% in children >11. Calcium intake was associated (p = 0.03) with BMC in the study group after adjusting for body size. The low-lactose diet resulted in a low calcium intake, and BMC was associated with calcium intake in prepubertal children with lactose intolerance. Evaluation of dietary calcium intake should be considered in this group of patients, with follow-up dietary counseling, calcium supplementation (diet or medication), and bone density assessment when clinically indicated.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SummaryThe impact of human recombinant growth hormone (GH) after massive small bowel resection was studied in 38 weaning female Wistar rats (65 + 5 days old; 193 + 26 g). Animals underwent a 80% small bowel resection, leaving in place similar lengths of jejunum and ileum. Animals were assigned to four groups: group A (n = 9), small bowel resection only; group B (n = 10), resection and treatment with 0.2 GH units (GHU) s.c. every other day; group C (n = 9), resection and 0.4 GHU; and group D (n = 10), laparotomy without intestinal resection. Twenty-eight days later, weight gain (percentage of initial weight) was 1 + 3 in group A, 12 + 8 in group B, 12 + 9 in group C, and 16 + 7 in group D; p < 0.001, groups B-D. Time to recover initial weight was 26.2 + 3.3 days in group A; 11.7 + 5.4 days in group B (p < 0.001); and 16 + 6.1 days in group C (p < 0.001 vs. A). The size of the intestinal remnant after the rats were killed was 1.3 + 0.6 cm (13 + 10% of initial length) in A; 5.15 + 2.4 cm (37 + 18%) in B (p < 0.01); 4.2 + 2.3 cm (33 + 20%) in C (p < 0.01 vs. A); and 4.4 + 3.5 cm (5.8 + 4.9%) in D (p < 0.001 vs A). Villus height and diameter, average number of mitosis per field, and muscular layer and wall thickness were greater in groups A, B, and C than in group D (p < 0.001). Villus height and muscular thickness of the jejunal part were increased in group C compared with A (p < 0.05). In conclusion, GH improves the postoperative intestinal adaptation process in terms of both weight gain and small bowel lengthening.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SummaryThis pilot study compared the use of bioelectric impedance analysis (BIA), a rapid, portable, and painless method of measuring body composition, to isotope dilution in patients with and without cystic fibrosis (CF). Many methods exist for measuring body composition but these measures can be difficult to use in the clinical setting. BIA has been validated as a tool for nutritional assessment in healthy adults, but it must be validated in patient populations with specific disease-related nutritional problems, such as CF. Ten ambulatory patients with CF were selected along with ten controls matched for age, sex, and body mass index (BMI; wt/ht2). Total body water (TBW) was determined using isotope-ratio mass spectrometry on urine specimens before and after patients consumed 0.2 g/kg deuterium-rich water. BIA was performed using a tetrapolar technique; 500 μA of current at 50 kHz was introduced and the voltage drop measured. Seven men and three women were studied in each group. Median age was 27 (range, 18–39) and median BMI was 19.2 (range, 16.7–30.1) in CF adults. Median age was 27.5 (range, 15–43) and median BMI was 20.7 (range, 19.4–31.6) in controls. The resistance index (RI; ht2/resistance) correlated strongly with TBW in patients with CF (r= 0.88;y= 0.482x+ 11.138;p< 0.05) as well as in controls (r= 0.87;y= 0.661x + 1.299;p< 0.05). We conclude that BIA is a rapid, portable, and painless method for measuring body composition that correlates well with the deuterium-dilution method. However, CF-specific regression equations will need to be developed and confidence intervals defined using large numbers of patients before this technique can be widely applied to patients with CF.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SummaryA series of in vivo steady-state perfusion studies in cholera toxin-induced secreting rat intestine were carried out to investigate net water, sodium, and potassium absorption and water influx and efflux from a range of oral rehydration solutions (ORSs) in which the glucose content had been partially replaced by amino acids or food supplements and the sodium content had been reduced to 60 mM.The reference solution used was the World Health Organization formula. There was a significant correlation between the osmolality of the ORS and the net water absorption (r= −0.911; p < 0.02). The greatest net water absorption occurred using comminuted chicken- and tapioca-supplemented ORS.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

SummaryThis study was carried out to determine the prevalence ofHelicobacter pyloriinfection in 20 neonates and young infants from lower socioeconomic background undergoing endoscopic retrograde cholangiopancreatography (ERCP) examination for diagnosis of neonatal cholestasis. One young asymptomatic infant (5%) who was breast-feeding with complementary formula hadH. pyloriinfection. Endoscopy showed a normal appearing mucosa and histology demonstrated mild superficial acute gastritis. A follow-up gastroscopy performed 14 months after the initial study showed normal histology without evidence ofH. pylorisuggesting that the infection was transient. Nineteen (95%) of the 20 mothers hadH. pyloriinfection, including the mother with the infant positive forH. pylori.All mothers had gastritis on biopsy specimens. Despite the high prevalence ofH. pyloriin the mothers, infection in neonates and young infants was uncommon.

ISSN:0277-2116    

出版商:OVID    

年代:1994

数据来源: OVID