ISSN:0277-2116    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Children with cystic fibrosis (CF) frequently have growth retardation. Standard growth velocity is dependent on an adequate supply of energy. The effect of dietary counselling and high energy food supplementation on the growth of eight children (aged 4 to 9 years) with CF was determined. The 2-year study was divided into control and test periods each lasting 1 year. Only during the test period did the mean energy intake reach or exceed 100% of the recommended energy requirements. When energy intake increased, weight growth increased significantly (p < 0.05). Even with pancreatic enzyme replacement, the CF subjects had increased fecal energy losses. Thus, since dietary energy intake would overestimate energy available for metabolism, absorbed energy was determined. There was a positive linear relationship between absorbed energy and weight gain (p < 0.01). Normal rates of weight gain were seen once absorbed energy intakes reached 100%-110% of requirements. The children grew in height and weight at normal rates during the test period, whereas they showed retarded growth during the control period. Our data provide evidence that children with CF have inadequate energy intakes. Furthermore, we have shown that absorbed energy intake is the principal factor limiting the growth of CF children in the age group studied. Finally. it is possible to promote normal growth in CF children with dietary counselling and high energy supplements.

ISSN:0277-2116    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Muscle electrolyte composition has been studied in 10 infants with marasmus and eight children with kwashiorkor. The presence of altered muscle salt and water concentrations was confined in the latter nutritional syndrome. The marasmic infant, with equivalent or more severe nutritional wasting than the child with kwashiorkor, maintained a more normal muscle electrolyte concentration as indicated by a number of criteria. The pathophysiology of the altered muscle composition in kwashiorkor remains unclear; however, it appears to be more specific than due just to a depletion of available fat and muscle stores. Although possible endocrine mechanisms can be postulated to explain the change in muscle chemistry, the existing evidence is inadequate. Clearly, continuing research is warranted.

ISSN:0277-2116    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

When conventional treatment with upright positioning and thickened feedings fails to control vomiting associated with gastroesophageal reflux (GER) of infancy, malnutrition and growth failure may result. If this occurs, fundoplication is usually recommended. In this study, 12 infants with growth failure associated with GER were given a trial of short-term (11.1 $PT SE 1.6 days) continuous-drip nasogastric (NG) feedings prior to surgical referral. Five of 10 infants for whom long-term follow-up (3− 12 months) was obtained showed immediate weight gain, cessation of vomiting, and long-term resolution of growth failure without the need for surgery. All infants who had a favorable long-term response showed evidence of catch-up growth during the first 7 days of NG feeding. Infants who did not begin catch-up growth during the first 7 days did not benefit from longer periods (up to 21 days) of NG feeding. Poor response to NG feedings was associated with the presence of other medical problems (p = 0.024), including chronic pulmonary disease, malabsorption, cerebral palsy, and laryngomalacia. Four infants who did require fundoplication still showed no improvement in growth 2–6 months after surgery. In infants with GER and growth failure without other complicating disorders, a 7− 10-day course of NG feeding may improve nutrition and bring about a permanent resolution of vomiting.

ISSN:0277-2116    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Duodenal biopsies from 33 celiac and 16 nonceliac patients were kept in organ culture for 24 h. Quantities of immunoglobulins were measured by rocket immunoelectrophoresis in mucus removed from the biopsy surface after culture and in culture media. Increased amounts of immunoglobulins were recorded after culture of biopsies from celiac disease patients in the exacerbation state: but only in 11 of 33 celiac mucosae could an increment be detected after culture in the presence of gluten compared to culture on glulen-free medium. The amount of IgA showed a significant correlation with radioactivity of mucus and culture medium after [14C]leucine incorporation during culture. In such experiments autoradiograms of immunoprecipitates disclosedin vitrosynthesis of IgA, whereas 47% of the IgG precipitates were radionegative. Amounts of IgA corresponded significantly to serum concentration of this immunoglobulin, whereas for IgM and IgG no such correlation existed. Quantification of immunoglobulins seems to be unsuitable as a method of evaluatingin vitrogluten toxicity in celiac disease.

ISSN:0277-2116    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Investigations by scanning electron microscopy into changes of surface morphology of small bowel ***nucosa in children with chronic nonspecific diarrhea are reported. The study population comprised 56 patients, ranging in age from 5 months to 7 years: 65% were between 10 and 28 months old, and 64% of the patients were boys. The major findings were: microorganisms on he mucosal surface: excessive extrusion of cell cytoplasm and of enterocytes (cell shedding): presence of excessive mucus on the mucosal surface: damage to the brush border; and partial villous atrophy. The latter lesion was found in only four patients. All these changes are considered pathologic and, for the most part, are presumed to be due to the presence of antigens, in particular, nicroorganisms. A depression of disaccharidase activities was encountered in 64% of the patients, but prevalence was without regard to age. Most common was a combined depression of lactase, sucrase, and maltase, as well as an isolated depression of lactase. The possibility has to be considered that enteroadherent microorganisms which are usually not considered pathogenic, and microorganisms such asMycoplasma, may emerge as intestinal pathogens in susceptible children. It is feasible that genetic traits of the host and environmental factors facilitate adherence and colonization of the small bowel mucosa which, in turn, produces chronic diarrhea. Further studies are needed to confirm the preliminary information contained in this report.

ISSN:0277-2116    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

To evaluate the possible contribution of enteric losses of $aP1-antitrypsin ($aP1-AT) to the low serum levels of $aP1-AT seen in patients with $aP1-AT deficiency, we investigated intestinal clearance of $aP1-AT (C-$aP1-AT) in five of these patients (mean age 3.4 years) and compared it to that of 10 patients (mean age 3.7 years) with gastrointestinal disorders and normal serum albumin values who served as controls. C-$aP1-AT was also determined in four patients (mean age 9 months) with noncirrhotic liver disease. The percent of daily $aP1-AT turnover which could be attributed to stool losses was calculated in these groups of patients, $aP1-AT was measured in stool and serum by radial immunodiffusion and the clearance calculated. The mean C-$aP1-AT in the patients with $aP1-AT deficiency was significantly (p < 0.05) higher than that of the controls. The liver disease patients had values for C-$aP1-AT in the range of the controls. Three of the $aP1-AT deficiency patients had values for C-$aP1-AT greater than the mean plus 3 SD of the control, but these were not in the range seen in patients with protein losing enteropathy. Mean percent contribution of stool losses to total daily $aP1-AT turnover was similar in all three groups. We conclude that patients with $aP1-AT deficiency have increased fecal clearance of $aP1-AT seemingly unrelated to the liver disease, but that this is not a major cause of the low serum levels.

ISSN:0277-2116    

出版商:OVID    

年代:1983

数据来源: OVID