Journal of pediatric gastroenterology and nutrition
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J. Pediatr. Gastroenterol. Nutr. · Dec 2006
EditorialSuccessful food-based programmes, supplementation and fortification.
This review highlights interventions and delivery mechanisms to alleviate macro- and micronutrient deficiencies in preschool children. These deficiencies can be addressed through an integrated combination of improved dietary intake, supplementation, commercial and home-based fortification of complementary foods. Several developed and developing countries have implemented successful approaches to eliminate protein-energy malnutrition and micronutrient deficiencies with sustained impact. ⋯ Often a period of voluntary fortification needs to be followed by mandatory requirement to ensure full compliance and sustained impact. The review concludes that proven technologies, communications and infrastructure can be harnessed to ensure that the nutrient needs of preschool children are met. When administered systematically with the commitment of and participation by the public and private sectors, most of the major deficiencies can be bridged on a sustained basis, contributing to improved health and well-being of millions of children around the world.
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J. Pediatr. Gastroenterol. Nutr. · Sep 2006
Pepsin, a reliable marker of gastric aspiration, is frequently detected in tracheal aspirates from premature ventilated neonates: relationship with feeding and methylxanthine therapy.
To determine the frequency of pepsin detection in tracheal aspirate (TA) samples of mechanically ventilated premature neonates and its association with feedings and methylxanthine therapy. ⋯ Pepsin, a marker of gastric contents, was detected in more than 92% of TA samples from premature infants on mechanical ventilation. The level of pepsin was higher in fed infants when compared with unfed infants. Xanthine therapy was also associated with increased pepsin in TA samples. Chronic aspiration of gastric contents may worsen lung disease in premature infants.
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J. Pediatr. Gastroenterol. Nutr. · Aug 2006
Randomized Controlled TrialSynergistic sedation with oral midazolam as a premedication and intravenous propofol versus intravenous propofol alone in upper gastrointestinal endoscopies in children: a prospective, randomized study.
The primary objective of the present study was to compare the required dose of intravenous (IV) propofol between group A (synergistic sedation with an oral dose of midazolam combined with IV propofol) and group B (IV propofol alone), in diagnostic upper gastrointestinal endoscopy (UGIE) in pediatric patients. The secondary objective was to compare the safety, the efficacy, the ease of IV line placement and the ease of separation from parents between the 2 groups. ⋯ Our data suggest that synergistic sedation with an oral dose of midazolam combined with propofol may benefit the children who undergo UGIE with regard to lower mean dose of propofol used, easier IV line placement, easier separation from the parents, less pain induced by the IV line placement and greater patient comfort.
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J. Pediatr. Gastroenterol. Nutr. · Aug 2006
Effect of Nissen fundoplication on gastric motor and sensory functions.
Bloating, abdominal pain, and early satiety have been reported in up to 30% of patients after Nissen fundoplication. We hypothesized that these postsurgical complications in children and young adults are linked to either the effects of surgery on gastric sensation, compliance or motor function or to preexisting physiological abnormalities. ⋯ After Nissen fundoplication, children with gastroesophageal reflux manifest the following: (1) reduction in gastric compliance, (2) increase in minimal gastric distending pressure, (3) exacerbation of the sensations discomfort with gastric distension and (4) no effect on gastric emptying.