摘要:

Background:The reliability of anthropometric measurements of term infants has not been studied sufficiently to determine if these measurements are reliable enough to be used in clinical practice and research. This study described the intra- and interexaminer reliability of the following anthropometric measurements: weight (WT), head circumference (HC), chest circumference (CC), abdominal circumference (AC), mid-arm circumference (MAC), and length.Methods:A convenience sample of 50 clinically stable term infants was studied. Two examiners obtained the six measurements twice using blank tape measures. The order of examiners was randomized and the examiners were masked to their own and the other examiners' measurements.Results:The intraexaminer mean absolute differences were as follows: WT = 1.88, 3.28 g; HC = 0.29, 0.29 cm; CC = 0.50, 0.78 cm; AC = 0.71, 0.77 cm; MAC = 0.36, 0.39 cm; length = 0.92, 1.18 cm. The interexaminer mean absolute differences were as follows: WT = 1.94, 1.66 g; HC = 0.37, 0.36 cm; CC = 0.59, 0.72 cm; AC = 0.99, 0.77 cm; MAC = 0.41, 0.57 cm; length = 1.57, 1.47 cm.Conclusions:These findings indicate that intraexaminer differences tended to be smaller than interexaminer differences for all measures except weight, which remained stable for intra- and interexaminer comparisons. These findings also suggest that weight and head circumference were the most reliable measures, whereas length and mid-arm circumference were the least reliable measures.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:Increased permeability to sucrose has been recently shown to be a good marker of gastric mucosal damage in adults.Methods:This test was evaluated in 40 children consulting for recurrent abdominal pain and the results were correlated with endoscopic and histologic findings and with the presence ofH. pylori.Results:The gastric mucosa was considered endoscopically normal in 31 children; 3 had duodenitis, and 6 had mild gastritis. Abnormal endoscopic findings were associated with increased urinary sucrose excretion (MANOVA F = 7.30;p= 0.002). In the 6 children with mild gastritis, mean sucrose excretion was twice that of controls (0.060 ± 0.024 vs. 0.029 ± 0.018, respectively;p= 0.019) and significantly higher than the group with duodenitis (0.037 ± 0.013;p= 0.038). The specificity and sensitivity of sucrose permeability test for detection of gastric damage were 90.3% and 83.3%, respectively.H. pyloriwas detected in 62.5% of children including all patients with mild gastritis, in 2 out of 3 with duodenitis and 17 out of 31 endoscopically normal controls. No differences in sucrose excretion were observed in relation with the presence ofH. pylorior histological findings in the control group.Conclusions:Urinary sucrose excretion is a good marker of mucosal gastric damage in children and may be used as a screening test in large groups of populations.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:Patients with cystic fibrosis are at risk for impaired vitamin K status due to fat malabsorption from pancreatic insufficiency. This study was designed to assess vitamin K status and measure the effect of vitamin K1supplementation in cystic fibrosis patients.Methods:Eighteen outpatients participated in a crossover study to determine the effect of vitamin K1(phylloquinone) supplementation. After obtaining initial data, each subject was randomly assigned to either a 4-week study treatment of 5 mg oral vitamin K1supplementation per week, or no supplementation and then crossed over to the other treatment for a second 4 week period. Plasma, serum and urine samples were collected and analyzed pre-study and at the end of each study period.Results:The mean concentration of plasma vitamin K1for the supplemented group was significantly higher than the unsupplemented group, [0.34 nmol/L and 0.21 nmol/L, respectively (p< 0.05)]. The percent of undercarboxylated osteocalcin increased on supplementation from 17% to 31%, (p< 0.005). Prothrombin induced in vitamin K absence (PIVKA-II) increased on supplementation from 5 ng/mL to 22 ng/mL, (p< 0.005). The ratio of urinary gammacarboxyglutamic acid/creatinine was similar for both study periods.Conclusions:In contrast to other studies in cystic fibrosis, this study demonstrated a need for vitamin K1supplementation. The carboxylation state of osteocalcin and PIVKA-II were the most sensitive indices of changes in vitamin K1status. Although the 5 mg vitamin K1/week dose improved these vitamin K parameters, normal levels were not achieved.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:Congenital chloride-losing diarrhoea is characterized by a defect in chloride/bicarbonate exchange, which is normally present in the ileum and colon. Whether the defect is an absence or a reversal of such an exhange is unclear, and we have investigated two young children with the disorder to answer this question.Methods:We used a previously described nonequilibrium rectal dialysis method, using different dialysate anion concentrations, to investigate the movement of sodium, potassium, chloride, and bicarbonate in the rectum of the two children.Results:The results showed that chloride and bicarbonate movements were not linked in any active way, and both ions appeared to move passively in response to the electrochemical gradients generated.Conclusions:In the two subjects studied, the defect in the rectum appears to be an absence of the normal anion exchange mechanism present in the bowel, rather than its reversal.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:Severe esophagitis is a rare complication of gastroesophageal reflux in children. In adults, omeprazole therapy of severe erosive esophagitis has become the gold standard short-term treatment of the disease. In children, data on its use are limited, and problems about the dosage are unresolved. The aim of this study was to evaluate the efficacy of a simplified, body-weight-based daily dosage of omeprazole in children with severe esophagitis.Methods:Ten children (median age 75.6 months; range 25-109 months) with severe esophagitis were prospectively investigated. All patients were evaluated by endoscopy, histology, and 24-h pH-metry study before and after 3 months of omeprazole. The starting dose of omeprazole was 20 mg as a single daily dose in children weighing less than 30 kg, and 40 mg daily for those weighing over 30 kg.Results:A significant improvement in all the children was demonstrated after 3 months of treatment by clinical, endoscopic, and pH-metry assessment. However, histologic study failed to show significant improvement of both inflammatory and hyperplastic findings. Relapse occurred in six of 10 patients after discontinuation of therapy.Conclusions:Omeprazole is effective in the short-term treatment of severe oesophagitis in children. The daily dose of the drug could be easily based on the body weight. The persistence of histologic features of esophagitis in spite of clinical and endoscopic healing could be an indicator of poor outcome.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:Elevated serum lipoprotein(a) [Lp(a)] concentrations have been demonstrated to be associated with cardiovascular diseases due to premature atherosclerosis. However, the association of Lp(a) phenotypes with the development of these diseases remains largely unexplored.Methods:We analyzed the population-based frequencies of serum Lp(a) phenotypes in 269 Japanese children aged 8-13 years in one community. According to the different apolipoprotein(a) [apo(a)] electrophoretic mobilities, Lp(a) was classified into seven single-band and respective double-band phenotypes. Each individual expressed a single (homozygotic) or a double band (heterozygotic).Results:The serum Lp(a) concentration frequency distribution was skewed toward lower levels with a mean ± SD of 15.5 ± 18.0 mg/dl and a median of 11.0 mg/dl. The Lp(a) phenotype frequencies revealed that the frequency of double-band phenotype expression (55%) was higher than that of single bands (44%) and that the frequency of phenotypes representative of low molecular weight apo(a) was very low (2%). The mean serum Lp(a) concentration of the double-band-expressing subjects was higher than that of subjects with the single-band phenotype (20.1 ± 19.9 vs. 10.5 ± 15.9 mg/dl, p < 0.01).Conclusions:These findings of Lp(a) phenotypes in children seemed to differ from those in Japanese adults in another study; contrary to expectation, the predominant Lp(a) phenotypes found in children were those frequently associated with cardiovascular diseases in adults. Thus, it is speculated that children whose Lp(a) phenotypes remain unchanged during the transition to adulthood may show an increased susceptibility to cardiovascular disease, although the nutritional effects on the Lp(a) phenotypes cannot be neglected.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:There is limited information in the literature on the capacity of the preterm infant to digest human and bovine milk proteins. We therefore studied in vivo the luminal phase of the hydrolysis of proteins in human milk, human milk fortifier, and preterm formula in preterm rhesus monkeys and in infant rhesus monkeys at 6 weeks and 7 months of age.Methods:Protein hydrolysis was followed by polyacrylamide gradient gel electrophoresis and electroimmunoassay. The serum level of absorbed unhydrolyzed human α-lactalbumin was measured by a radioimmunoassay method. Trypsin and elastase activities in duodenal contents were measured before and after the meal.Results:In 6-week-old monkeys, the enzyme activities decreased by 50% postprandially, whereas they increased in 7-month-old monkeys. In preterm and in 6-week-old monkeys, hydrolysis of human and bovine whey proteins was slow, and in 6-week-old monkeys, 30-50% of the proteins could still be detected immunochemically in duodenal contents after 60 min. At these ages, serum levels of absorbed α-lactalbumin were high. At 7 months of age, no or small (lactoferrin and bovine serum albumin) amounts of the proteins could be detected in duodenal contents after 15 min. At this age α-lactalbumin was not measurable in serum.Conclusion:The low capacity to digest whey proteins in suckling monkeys may depend upon an immaturity of the exocrine pancreas to respond to secretogogues.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:It is believed that the incidence of cystic fibrosis (CF) among Asiatic races, including the Japanese, is very rare. This epidemiological study was carried out to investigate the incidence of CF in Japan.Methods:We collected literature describing CF cases among pure Japanese and found 124 cases reported as CF during the 43 years from 1951, when the first case was reported, to 1993. Only 104 cases (57 male and 47 female patients) of 124 cases met our diagnostic criteria.Results:A simple calculation based on the number of reported CF cases and of live births after 1980 suggested that the incidence of CF is about 1 in 350,000 in the Japanese population. Twenty-nine (27.9% of the total) of 30 patients diagnosed in the neonatal period presented symptoms of meconium ileus, an incidence higher than that reported for the white population.Conclusions:Our study results suggest that the incidence of CF in the Japanese population is even rarer than had been estimated before and that there is a genetic difference between northern European and Japanese populations.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID