ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The cutoff limit for pathologic gastroesophageal reflux (GER) has been arbitrary, although generally accepted determined at pH 4.00. The influence of a small pH error (0.25 pH units above or below pH 4.00) was analyzed in 173 consecutive pH monitorings. This appeared to cause a misinterpretation of the data in 51 of 173 infants (29%). We propose the introduction of a new parameter measuring the percent of time of the total investigation that the recorded pH varies between 4.25 and 3.75: the “oscillatory index” (OI). The index ranged from 0–42%. The higher the OI, the more pH data that are recorded between pH 4.25 and 3.75. The OI is related to the arbitrary aspects of a boundary level. The Pearson correlation coefficient between the percent of time of the investigation the pH was

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Twenty-three children with Helicobacter (Campylobacter) pylori-associated chronic gastritis are reported. Family history of peptic disease, previous digestive procedures, and nonspecific epigastric pain were the most frequently encountered clinical features. Antral nodularity at endoscopy and histologic evidence of follicular gastritis were characteristic morphological aspects. Rapid urease tests suggested the diagnosis in 90% of patients. Significant increases of serum IgG and IgA against Helicobacter pylori allowed the identification of infected children with 95% cumulative sensitivity. Treatment with amoxicillin and bismuth subcitrate eradicated the infection and improved gastritis in 13 of 19 children. These findings provide further evidence for the etiologic role of Helicobacter pylori in chronic antral gastritis in children.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Small premature infants are often hypochlorhydric, and frequently their stomachs are colonized by enteric, gram-negative bacteria. We tested a hypothesis that gastric pH affected the colonization of the stomach with enteric bacteria and that this colonization was causally related to the risk or severity of necrotizing enterocolitis. A prospective, double-blind study was conducted that compared a group of infants supplemented with 0.01–0.02 ml of 1 N HCl/ml of milk to a group with a similar supplement of water. Gastric pH, gastric enteric bacteria counts, and the incidence and severity of necrotizing enterocolitis were monitored. The median gastric pH of the HCl-supplemented group was lower (3.0) than controls (4.0) throughout the study (p < 0.001). The gastric enteric bacterial colonization rate and the quantitative bacterial counts were strongly correlated with gastric pH over 4 (p < 0.001). Somatic growth rates in infants in the HCl-supplemented group were equal to, or exceeded, those in the control group. There was 1 case of necrotizing entero-colitis among the 34 infants in the HCl-supplemented group and 8 cases among the 34 in the control group (p = 0.02). It appears that acidifying the feedings of small premature infants to a pH low enough to inhibit bacterial proliferation in the stomach significantly lowers the risk of necrotizing enterocolitis.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The only presenting clinical feature of diagnosing celiac disease (CD) late may be short stature. At the start of treatment with a gluten-free diet (GFD), celiac children show an accelerated growth rate. The real duration of catch-up growth and influence of diet on the final stature has not yet been defined. In order to evaluate the effect of a GFD on growth parameters, 24 children diagnosed late with CD were studied at our center. During the period of diagnosis, weight, height standard deviation score (HSDS), weight and height velocities (WV and HV), bone age (BA), and pubertal stage were recorded. Predicted height (PH) according to the Tanner method, parental height, and target height (TH) were also evaluated at diagnosis. All patients initially presented because of short stature or retarded growth (100% of patients with height

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The serum levels of β2-microglobulins (β2-m) were studied in 65 celiac children. Significant statistical differences (p < 0.05) were found between the values of patients on a gluten-containing diet (mean ± SD, 1.92 ± 0.64mg/L) and those on a gluten-free diet for less than (mean ± SD, 2.38 ± 0.76 mg/L) or greater than (mean ± SD, 1.46 ± 0.77 mg/L) 8 months. A significant difference was also found between the first group and the 15-subject control group, who underwent intestinal biopsy for low stature or chronic diarrhea but had normal intestinal mucosa (mean ± SD, 1.56 ± 0.42 mg/L). Serum β2-m levels were above normal values (2-m values of patients on a gluten-free diet for ±8 months were significantly different (p < 0.001) from those of patients on a gluten-free diet for >8 months, as well from those of the control group. No significant differences were found between patients on a gluten-free diet for >8 months and the control group. A significant correlation between the anti-gliadin antibody (AGA) IgA and β2-m in the patients on a gluten-free diet for >8 months and control-group patients was found. The significant statistical difference (p < 0.05) of the mean values of β2-m between patients with DR3+/DR7− and DR3+/DR7+ phenotypes (if confirmed by a wider case study) could indicate a genetic heterogeneity of celiac disease. The β2-m, because of its specificity (86.7%), even if the sensitivity (38.5%) is not high, could be used with AGA to select candidates for intestinal biopsy. The increase of β2-m serum levels in the first months of the gluten-free diet is probably due to active regeneration of the intestinal mucosa. As the time necessary for serum values being normal is about 8 months, this could be the gluten-free period necessary before proceeding to a second biopsy.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A dot immunobinding assay to detect anti-α-gliadin-specific antibodies in the sera or whole blood of enteropathic patients is described here. The method is based on the adsorption of α-gliadin as a spot onto nitrocellulose sheets. After incubation with the patient sample, the detection of specific antibodies is performed with alkaline phosphatase-conjugated goat anti-human (IgA or IgG) antibodies. Twenty-one celiac serum samples together with 18 enteropathic or disease controls and 44 healthy controls were analyzed. The classical ELISA test and the dot test gave comparable results. The dot test gave reliable result even when whole blood was tested. The method proved to be simple and sensitive.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

An increase in energy intake often occurs at weaning. The increase may be due partly to prompting by the caregiver to accelerate the child's weight gain and partly motivated by the palatability of common weaning foods. Increased food intakes initiated during weaning and continued into the second year of life may be associated with chronic, nonspecific diarrhea in selected children. An educational project was designed to reduce intakes augmented by either cause. Reductions were achieved by the regulation of energy-dense foods in the child's diet and reliance on the child's appetite control to determine meal size. The educational intervention was applied prospectively under nonblinded, controlled conditions. Children, 1 to 2 years of age, with chronic nonspecific diarrhea were assigned randomly to either a treatment or control group. Compliance, food consumption, preprandial glycemia, and outdoor activities were reported by the children's mothers in four 7-day diaries; symptoms related to the children's clinical condition and anthropometric and biochemical indices of nutritional status were noted at the beginning and end of a 7-month period. Forty-four of 53 children in the experimental group maintained compliance, and 44 of 47 children in the control group completed the follow-up. Energy intake decreased significantly by almost one-third in the experimental group. Growth, skinfold thickness measurements, and outdoor activities were similar between experimental and control groups over the 7-month period. Diarrheal episodes occurred in 6, 1, and 2 children in the experimental group at 1.5, 3, and 7 months and in 22, 18, and 15 children in the control group, respectively (p < 0.002). Twenty of 32 parameter of clinical status were more advantageous in the experimental group compared to 9 of 32 in the control group in a comparison of the mean values in the two groups at the final examination (p < 0.05). Serum folate (p < 0.001) also was significantly higher in the experimental group. The described intervention appeared to achieve lower energy intakes in a safe and reproducible manner. It may be a useful tool to prevent overeating and control signs and symptoms associated with chronic, nonspecific diarrhea.

ISSN:0277-2116    

出版商:OVID    

年代:1990

数据来源: OVID