Journal of pediatric gastroenterology and nutrition
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J. Pediatr. Gastroenterol. Nutr. · Feb 2005
Gastroesophageal reflux disease in infants: how much is predictable with questionnaires, pH-metry, endoscopy and histology?
Symptoms of gastroesophageal reflux disease (GERD) are common in infants. It is often difficult to discriminate between physiological and pathologic gastroesophageal reflux, although this discrimination is essential to determine which infants to evaluate and treat. ⋯ Clinical symptoms, histology and pH study show poor correlation in infants. Clinical symptoms such as regurgitation and crying are less frequent in unselected infants than in infants suspected of gastroesophageal reflux disease. However, questionnaires are poorly predictive for the severity of gastroesophageal reflux disease, as they do not correlate with esophageal acid exposure as measured by pH-metry and with esophagitis as evaluated by histology of esophageal biopsies.
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J. Pediatr. Gastroenterol. Nutr. · Oct 2004
Variations in incidence of necrotizing enterocolitis in Canadian neonatal intensive care units.
Necrotizing enterocolitis (NEC) is the most common acquired intestinal disease of neonates. Previous reports on incidence have generally examined small cohorts of extremely low-birth-weight infants and have not examined risk-adjusted variations among neonatal intensive care units (NICUs). The authors examined risk-adjusted variations in the incidence of NEC in a large group of Canadian NICUs and explored possible therapy-related risks. ⋯ Risk factors for NEC were different in VLBW and HBW infants. There was no significant variation in the risk-adjusted incidence of NEC among Canadian NICUs, with one possible exception.
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J. Pediatr. Gastroenterol. Nutr. · Oct 2004
Extraction of di-ethylhexyl-phthalate from perfusion lines of various material, length and brand by lipid emulsions.
The plasticizer di-ethylhexyl-phthalate (DEHP) is extracted especially by lipid emulsions from polyvinylchloride infusion systems. The aim of this study was to systematically examine the extraction from perfusion lines commonly used in our hospital for lipid emulsion infusions. ⋯ Lipid emulsions contain a production-inherent load of DEHP. Perfusion through PVC-perfusion lines extracts a varying large amount of DEHP depending on length and brand of the perfusion lines. Co-extruded PVC/PU and PVC/PE lines, intended to avoid DEHP contamination, leach a similar amount of DEHP and thus do not avoid the DEHP toxicity issue. The load accumulated by a baby on an intensive care unit easily reaches several milligrams of DEHP per day. As its effect upon biologic systems has been proven, and alternatives (PE or PU perfusion lines) are available, PVC and PVC co-extruded perfusion lines should be abandoned for infusions, especially in babies.