ISSN:0277-2116    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0277-2116    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryTo establish whether cisapride is beneficial in children with intractable constipation, an open trial was performed. Chronically constipated children who had failed at least 12 weeks of medical therapy received cisapride at a dose of 0.2 mg/kg/dose TID for 12 weeks. Children with pelvic floor dyssynergia were excluded. Patients were followed prospectively for at least 12 months. Thirty children were initially enrolled, and 27 (14 boys, 13 girls) completed the study. At the end of 12 weeks of cisapride treatment, there was a significant increase in the number of bowel movements per week (1.43 ± 0.52 to 6.48 ± 4.16;p< 0.05) and significant decreases in the number of accidents per day (2.86 ± 2.71 to 0.52 ± 1.23;p< 0.05) and doses of laxatives used per week (14.33 ± 5.84 to 3.37 ± 7.10;p< 0.05). Encopresis disappeared in 65.2% of cases (p< 0.0001) and improved in 26%. Sixtynine percent of the patients stopped using laxatives (p< 0.001). After 12 weeks 18 patients (66.6%) were asymptomatic, seven (25.9%) showed some improvement in bowel movement frequency and number of accidents, and two (7.4%) showed no improvement. The cisapride was well tolerated. After long-term follow-up (20 ± 9.8 months), 37% of patients had recovered (asymptomatic and off laxatives and cisapride) and 29.6% were still asymptomatic but were using laxatives or cisapride. There were no differences in baseline characteristics between recovered and nonrecovered patients. We conclude that cisapride is effective in the treatment of some children with intractable constipation without pelvic floor dyssynergia.

ISSN:0277-2116    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryTwelve children with achalasia were treated by the technique of balloon dilatation in the years 1984-1991. Follow-up from 2 to 8 years (mean 3.5 years) showed complete relief of obstruction in 10 patients, while two required esophagomyotomy. Balloon dilatation is effective in the treatment of achalasia.

ISSN:0277-2116    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryTen exclusively gastrostomy-fed, neurologically impaired children (4.5-14.5 years old) with gastroesophageal reflux were randomly assigned to receive feedings with either a casein- or a whey-based formula for 48 h each and then crossed over to the other formula. One 24-h pH probe study each was performed while being fed casein- and whey-based formula, respectively. There was a significant reduction in episodes and duration of gastroesophageal reflux while consuming the whey-based formula (p < 0.05). Whey-based feedings should be considered an additional tool in conjunction with other antireflux measures to treat gastroesophageal reflux more effectively in children with severe neurological impairment. A similar study was also conducted involving 14 infants (3-12 months old) with documented gastroesophageal reflux using 24-h pH probe monitoring while consuming a casein-based formula. The formula was changed to a whey-based formula and the pH probe study repeated within 3-5 days. Four infants showed improvement and the rest showed either deterioration (1/14) or comparable results (9/14). The reduction in the mean number of episodes or duration of gastroesophageal reflux with the whey-formula was not significantly different from that with the casein-based formula (p > 0.05). Based on these findings, generalized recommendations for the use of whey-based formula in infants with gastroesophageal reflux cannot be made.

ISSN:0277-2116    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryOur objective was to determine the ability of several clinical signs of dehydration to distinguish among degrees of dehydration in infants with acute diarrhea. The design was a prospective cohort study in a pediatric referral hospital in Cairo, Egypt. Infant boys, 3-18 months old, with a history of acute diarrhea (5 or more watery stools per day for no more than 7 days) were eligible, except those with frank protein-energy malnutrition, serious nongastrointestinal illness, or being exclusively breast-fed. Several clinical signs of dehydration were assessed upon study entry. Subjects were then rehydrated with an oral rehydration solution and fed a standardized diet until diarrhea ceased (no watery or loose stools for 16 h). The main outcome measure was percent body weight gain at rehydration and at resolution of illness. Data from 135 subjects were available for analysis. Average (SD) rehydration phase duration was 5.2 (2.1) h, and average (SD) duration of illness was 54.5 (38) h. Multiple regression analysis selected prolonged skinfold, altered neurologic status, sunken eyes, and dry oral mucosa as the clinical signs that correlated best with percent dehydration (R2for model 0.244, p < 0.001). Mean weight gain for the two assessment systems was 3.6-3.9% for mild, 4.9-5.3% for moderate, and 9.5-9.8% for severe dehydration. The most valid clinical signs of dehydration include prolonged skinfold, altered neurologic status, sunken eyes, and dry oral mucosa. Children with clinical signs of mild or moderate dehydration have fluid deficits on the order of 3 or 5% body weight, respectively.

ISSN:0277-2116    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

SummaryThe effect of feeding hydrolysate infant formula (HF) on protein and amino acid metabolism was investigated in healthy, full-term infants who were either breast-fed (BF, n = 10) or received conventional formula (CF, n = 10) or HF based on soy and beef collagen (n = 10) with equal total protein equivalent contents. There were no differences between groups for gain in weight, length, and head and chest circumferences throughout the study. Plasma concentrations of total proteins, albumin, urea nitrogen, uric acid, and creatinine as well as total amino acid and total essential amino acid concentrations did not differ at the ages of 2, 4, and 8 weeks. In contrast, significant differences were seen in concentrations of five free amino acids. Arginine concentrations were significantly higher at the age of 4 weeks in the infants fed HF than in the other groups (71 ± 12 versus 27 ± 6 and 30 ± 4, μmol/L, mean ± SEM, HF versus BF and CF, p < 0.01). Plasma histidine concentrations were also higher in infants receiving HF (4 weeks: 217 ± 33 versus 91 ± 18, HF versus BF, p < 0.01; 8 weeks: 218 ± 33 versus 105 ± 20, HF versus CF, p < 0.01). The most pronounced feeding-related differences were seen in plasma glycine concentrations (2 weeks: 653 ± 89 versus 345 ± 55, HF versus BF, p < 0.01; 8 weeks: 613 ± 74 versus 385 ± 56 and 312 ± 46, HF versus BF and CF, p < 0.01), with the mean value exceeding the upper limit of the normal range in infants fed HF. Although the biological importance of the differences observed remains to be clarified, further investigations on amino acid metabolism are needed to establish the final nutritional safety of feeding hydrolysate infant formulae.

ISSN:0277-2116    

出版商:OVID    

年代:1996

数据来源: OVID