摘要:

BackgroundAddition of a small amount of amylase rich flour (ARF) to a thick porridge instantly liquefy the porridge and increase the energy intake even by sick children. The present study examined the absorption of macronutrients and calorie from an energy dense diet liquefied with ARF in children aged 6-11 months with acute watery diarrhea.MethodsAfter adequately hydrated with oral rehydration fluid over a period of 24 hours, children were randojmly assigned to receive either an ARF treated liquefied porridge (test diet) or a porridge diluted with water (control diet). A 72-hour metabolic balance was performed to determine the absorption of carbohydrate, fat, protein, and calorie.ResultsThirteen infants received the test diet, and 15 infants received the control diet. The intake of protein (g/kg/d), carbohydrate (g/kg.d), fat (g/kg.d) and calorie (kJ/kg.d) were 1.97, 20.6, 4.3 and 548 respectively in the test group and those in the control group were 1.12, 13.3, 2.8 and 356. The stool loss of protein, carbohydrate and fat were comparable in the two groups. The absorption coefficient (%) of carbohydrate, fat and energy were 69.6, 61.3 and 65.4 in the test group and were 73.2, 58.6 and 66.7 in the control group. The coefficient of absorption of protein was significantly higher in the test group (37.7% vs. 21.7%). The mean (95% CI) nitrogen balance (g/kg.d) in the test and control groups were 0.064 (0.026, 0.102) and -0.029 (-0.055, 0.003) respectively.ConclusionsThe results suggest that energy dense diet liquefied with ARF was well absorbed in children with acute diarrhea and there was a positive nitrogen balance that may have a positive impact in preventing weight loss during acute illness.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:While in the adult Al intoxication requires high dosages, little is known on the threshold level of Al toxicity in the young.Methods:Weaning rats were fed for 90 days ore of four diets differing by their content in Ca (7.5 vs <0.5g/<g diet)(Ca +/-) and Al (10.6 vs 8.4 mg/kg)(Al +/-); Al supplementation was 30% above the standard level of diet. Ca and Al levels were measured in liver, bone (femur), and brain.Results:Ca- had a significant negative effect on growth which was further reduced by Al+; in Ca sufficient/Al+ animals, Al concentrations were significantly increased in bone and brain and tended to increase in liver; Ca decreases observed in these three organs were only significant in brain. Ca deficiency further enhanced the Al deposit in bone at both levels of Al intakes, and reduced Ca concentrations in these three organs in Al+ animals; in Ca-/Al- animals, the decrease in Ca displayed in the three tissues reached a significant level in brain.Conclusions:This study suggests that in the growing subject the side effects of small variations of Al intake can be enhanced when they are combined with other mineral imbalances.

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:Liver transplantation is the therapeutic choice for fulminant hepatic failure in children.Methods:All 66 cases of fulminant hepatic failure in the pediatric population seen at UCLA from May, 1985 to November, 1993 were reviewed to determine changes in survival rates since the advent of liver transplantation. We evaluated the clinical course and events leading to the exclusion of surgical management of nonsurvivors, who otherwise would have benefited from a liver transplant. We also compared the latter's clinical course with the nontransplant survivors to determine parameters for screening patients for liver transplantation.Results:Fifty-one patient (77%) were put on the transplant list initially but eventually, only 38 (58%) patients underwent orthotopic liver transplantation (OLT) and of these 30 (79%) patients survived. Of the remaining 29 (42%) patients who did not undergo liver transplantation, only 10 (36%) patients survived. Nine patients died while waiting for a donor liver secondary to complications of hepatic failure. The majority of nonsurvivors in the OLT and no-OLT groups succumbed because of irreversible neurologic deterioration. In the no-OLT group, comparisons between survivors and non-survivors were made. There were no significant demographic differences. It took a mean of 8 days (±8) versus 22 days (±15), (p = 0.009), from onset of illness to first hospital admission for survivors and nonsurvivors, respectively. Time to reach stage II encephalopathy was a mean of 5 days (±5) for survivors versus 18 days (±16), (p = 0.05) for nonsurvivors. Nonsurvivors were transferred to the transplant center at a mean of 12.2 days (±12) after being first admitted elsewhere as compared to a mean of 1.9 days (±18) for survivors, (p = 0.02). Mean prothrombin time decreased by a mean of 13.4 s/day (±16) for survivors as against 2.25 s/day (±6) for nonsurvivors, (p = 0.06). Mean peak total bilirubin for nonsurvivors was 460 μmol/L (27 mg/dl) versus 220 μmol/L (13 mg/dl) for survivors, (p = 0.06). Nonsurvivors died at a mean of 30 days (±19) from onset and survivors' liver tests started to improve at a mean of 11 days (±9) from onset.Conclusions:From these studies, we conclude that liver transplantation remains the therapeutic choice for fulminant hepatic failure in children. Early referral and closer follow-up is necessary for timely admission to liver transplant centers to enable screening and proper preparation of these patients for liver transplantation.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:An association ofH. pyloriinfection with chronic gastritis, peptic ulceration and gastric cancer is known.Methods:Prevalence of IgG antibodies toHelicobacter pyloriin children in the Bloemfontein, South Africa area was studied. Children attending the general pediatric out-patient department at Pelonomi Hospital in Bloemfontein were grouped according to age. A minimum of 100 children was investigated in each age group. Baseline demographic and socioeconomic data were collected.Results:The study showed a high prevalence ofH. pyloriantibodies. Prevalence increased with age: 13.5% in children 3 months-2 years, 48.5% at 2-5 years, 67.3% at 5-10 years and 84.2% at 10-15 years. Investigation of the socioeconomic data in relation to the prevalence ofH. pyloriwas inconclusive.Conclusions:This high prevalence needs further study.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:Addition of soy polysaccharide to infant formulas has previously been shown to reduce the duration of diarrhea in infants with acute gastroenteritis. Fiber is metabolized to short-chain fatty acids that have been shown to be beneficial in inducing adaptation in the small bowel. We therefore hypothesize that a soy-polysaccharide-supplemented infant formula may be potentially advantageous in the treatment of patients with short bowel syndrome and could have a trophic effect on the remaining small intestine.Methods:Male Spraque-Dawley rats weighing 250 g were divided into two groups. One group received Isomil, a standard infant soy formula. The second group received Isomil supplemented with fiber, Isomil DF. Half the animals in each dietary group were subjected to 80% jejunoileal resection and the reminder were sham operated. Animals were pair-fed one of two diets for 14 days. At the conclusion of the 14-day period, mucosal weight and sucrase and lactase levels in the remaining duodenum and ileum were determined.Results:Resected animals fed fiber-supplemented formulas had significantly higher sucrase and lactase levels in the proximal bowel. Comparable results were not observed in the sham-operated animals.Conclusions:The addition of soy polysaccharide to infant formulas fed to children with short bowel syndrome might potentially improve small intestinal functional adaptation as well as positively affecting stool consistency.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:The prevalence of primary sclerosing cholangitis, a rare progressive liver disorder, is increasing with the advent of endoscopic retrograde cholangiography in the investigation of children with obscure liver disease. The etiology of primary sclerosing cholangitis is not known, clinical presentation is variable, treatment is only of limited success and long-term studies on prognosis in children are incomplete. Primary sclerosing cholangitis has not been described in Arab children.Methods:To describe detailed clinical, laboratory, histologic and radiological features in 4 children with primary sclerosing cholangitis identified over a 2-year period at a tertiary referral center in Riyadh Saudi Arabia.Results:Four children, all females, between the ages of 4 and 11 years with primary sclerosing cholangitis are identified. The diagnosis was suggested by the histology and confirmed by the characteristic cholangiographic findings. Clinical findings were itching in all 4 children, hepatomegaly in 3 and splenomegaly in 4 patients. Three of 4 patients had portal hypertension and 2 of these three variceal hemorrhage. Antinuclear and smooth muscle antibodies were negative in all four patients. None had clinical manifestations of chronic inflammatory bowel disease but microscopic colitis was documented in all 4 patients.Conclusions:Primary sclerosing cholangitis is present in Arab children with a prevalence rate of 5% in our study population.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:It has been suggested that beneficial effect of elemental enteral diets in the treatment of inflammatory bowel diseases could be mediated by the suppression of protein dietary antigens. The objective of the present work was to study the effect of enteral diet on gut associated lymphoid tissue and on gastricLactobacillusflora, in rat.Methods:The effects of three molecular forms of nitrogen supply: aminoacids, oligopeptides or whole casein, were compared in rats on continuous enteral diet. Frozen sections of small bowel were studied with monoclonal antibodies anti-CD5, -CD4, -CD8, -CD25, -macrophages, -MHC II. TheLactobacillusflora was also enumerated in the stomach, in order to assess the effect of ED on rat flora.Results:Growth and mucosa morphology were identical in control and enteral groups. Rats on enteral diet showed, whatever was the molecular form of nitrogen supply, a decrease in CD5+, CD4+ and CD8+ intraepithelial cell numbers, but not in lamina propria cell number, and a decreased MHC II epithelial expression, when compared to control rats. The enterally fed rats also showed a decrease inLactobacillusgastric contents.Conclusions:The current study demonstrates that continuous enteral nutrition modifies MHC II epithelial expression and gut associated lymphoid tissue cell number in rat, whatever is the molecular form of nitrogen supply. Intestinal flora could be responsible, at least for part, for these results.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:The capacity to generate (interferon-gamma) IFN-γ, a potent immunoregulatory and inflammatory cytokine, is low in neonates and deficient in patients with food allergy.Methods:We investigated the effect of IFN-γ on antigen transport in the gut. In experiment I rat pups were randomized into two groups at the age of 14 days i.e., before gut maturation: Group IFN was given intraperitoneally recombinant rat IFN-γ on days 14, 16, 18, 20. In experiment II, rats were randomized into two groups at the age of 26 days, i.e., after gut maturation: Group IFN received the IFN-γ treatment on days 26, 28, 30, 32. Controls in both experiments received sterile saline. The absorption of horseradish peroxidase (HRP) across jejunal segments with and without Peyer's patches was studied in Ussing chambers on days 21 and 33 for experiments I and II, respectively.Results:In experiment I, the absorption of intact HRP across both types of segments was significantly increased in Group IFN compared to controls. The mean (95% confidence interval) rate of degraded HRP absorption across patch-containing segments in Group IFN was significantly greater than in controls, 4420 (3162-6179) ng · h-1· cm-2in comparison to 1550 (633-3790) ng · h-1· cm-2; F = 8.96, p = 0.009.Conclusion:IFN-γ increases macromolecular transport before gut maturation particularly across Peyer's patches. This Peyer's patch-targeted effect can be important eliciting mucosal immune responses against dietary antigens early in life and aiding their immune exclusion.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Background:Bone metabolism may be disturbed in children with celiac disease.Methods:Two markers of bone turnover were used: the level of osteocalcin (BGP) and the level of carboxylterminal peptide of type I procollagen (PICP). BGP and PICP were measured by radioimmunoassays in 18 untreated children with celiac disease (mean age: 22.9 ± 15.6 months) and in 15 control subjects (mean age 28.5 ± 21 months). All the patients were rechecked after 1 month and again after 3 months from beginning of a gluten-free diet (GFD).Results:Compared with controls at diagnosis our patients had significantly lower serum levels of BGP and PICP (p = 0.003 and p = 0.018 by Student'sttest, respectively). These levels increased markedly during the 1st 3 months of GFD.Conclusions:The alteration in calcium phosphate homeostasis caused by celiac disease directly affects the synthesis of both components of the connective matrix of bone. Measurements of BGP and PICP provide a reliable and rapidly obtainable index of normalization of the processes of bone growth which can be achieved with a GFD.

ISSN:0277-2116    

出版商:OVID    

年代:1997

数据来源: OVID