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Biomedical subjects

H R Jenkins

Publications and source records attributed to H R Jenkins.

At least 37 records · Page 2Linked to original sources
PubMed1996

The epidemiology of paediatric inflammatory bowel disease.

A retrospective study of the incidence and prevalence of paediatric inflammatory bowel disease over an 11 year period was undertaken in South Glamorgan. Over this time the incidence of Crohn's disease more than doubled from 1.30 cases per 100,000 childhood population per year in the period 1983-1988, to 3.11 cases per 100,000 population per year in the period 1989-1993. In contrast, the incidence of ulcerative colitis remained the same throughout the study period at 0.71 per 100,000 per year. In 1993 the prevalence of Crohn's disease in the childhood population was 16.6 per 100,000 and of ulcerative colitis, 3.42 per 100,000.

Adolescent↗
PubMed1996

Nucleotide supplementation and the growth of term small for gestational age infants.

A double blind randomised controlled trial in small for gestational age (SGA) infants, whose intestinal mucosa was shown to be functionally impaired as a result of intrauterine undernutrition, was carried out to investigate the hypothesis that nucleotide supplementation of a milk formula could improve catchup growth. Anthropometric data were collected on 74 infants, 39 randomly allocated to the nucleotide supplemented group (group N) and 35 to a standard formula group (group S). From study entry to 2 months of age, infants in group N had significantly higher mean rates of weight gain (106.3 compared with 94.7 g/kg baseline weight/week) and length gain (21.8 v 19.7 mm/m baseline length/week). Over the whole six months for which the trial formula was provided group N had significantly higher mean rates of gain of weight (80.1 compared with 71.8 g/kg baseline weight/week), length (16.2 compared with 15.0 mm/m baseline length/week), and head circumference (11.8 compared with 10.8 mm/m baseline head circumference/week). Catchup growth in SGA infants is therefore improved by nucleotide supplementation of infant formula.

Anthropometry↗
PubMed1995

Absorption of a new oral formulation of cyclosporin A in a child on parenteral nutrition.

A 2-year-old child underwent renal transplantation in the presence of a post-viral enteropathy rendering him dependent on total parenteral nutrition. As part of his immunosuppression, he was given a new oral formulation of cyclosporin A (Neoral), which he was able to absorb satisfactorily, using conventional doses, during the 6 weeks he was dependent on intravenous nutrition and in the face of intermittent severe diarrhoea. An unusual pharmacokinetic profile was observed.

Administration, Oral↗
PubMed1995

Osteopenia in Crohn's disease.

A 16 year old boy presented soon after diagnosis of Crohn's disease with diffuse osteopenia of the lumbar spine with collapse of three vertebral bodies and grossly reduced bone mineral density noted on dual energy x ray absorptiometry scan. Treatment of the underlying Crohn's disease and induction of puberty resulted in marked improvement in bone mineralisation.

Absorptiometry, Photon↗
PubMed1995

Radiological assessment of constipation.

A scoring system for faecal loading was constructed by two experienced observers using the abdominal radiographs of 20 children. Four other observers independently graded the radiographs using this system and there was a high degree of agreement between all six observers (p < 0.001), suggesting that radiological assessment of constipation can be standardised.

Adolescent↗
PubMed1995

Radiological evidence of constipation in urinary tract infection.

Little objective evidence has been published to support the claim that constipation is an important contributory factor in recurrent urinary tract infection (UTI) in childhood. Using a radiological scoring system, two observers assessed faecal loading from abdominal radiographs of children with proved UTIs. There was a significant increase in the degree of faecal loading in children with UTI when compared with controls (r = 0.237). This difference was mainly accounted for by girls with recurrent (greater than five) UTIs. This study confirms an association between recurrent UTI and faecal loading. Further studies are needed to establish if there is a causal relationship and benefits from treatment.

Adolescent↗
PubMed1994

Constipation and reversible urinary tract abnormalities.

Urinary tract anomalies were prospectively investigated with ultrasound in 29 children with functional constipation. These children were compared before and after treatment with 451 age matched healthy controls without constipation. The bladder residue and upper renal tract dilatation after micturition were significantly increased in the group with constipation and improved after treatment.

Adolescent↗
PubMed1994

Systemic vasculitis complicating infantile autoimmune enteropathy.

An infant with unexplained sideroblastic anaemia and severe protracted diarrhoea due to autoimmune gut disease is reported. Despite treatment with an exclusion diet and immunosuppressive agents she developed a severe systemic vasculitic illness. Intensive treatment with plasmapheresis resulted in resolution of the vasculitic process but the child subsequently died after overwhelming septicaemia.

Anemia, Sideroblastic↗
PubMed1993

The effect of colitis on large-intestinal electrolyte transport in early childhood.

The large intestine plays an important role in the salvage of electrolytes and water, although little is known of its function in early childhood in health or in disease. Using an in vitro voltage clamp technique, we have measured bidirectional sodium (Na) and chloride (Cl) fluxes (J), electrical potential difference (PD), short circuit current (Isc), and tissue resistance (R) in 10 pairs of healthy human infant left colon and four pairs of inflamed colon. In healthy tissue there was net Na and Cl absorption with JNa net approximating Isc. In contrast, inflamed colon exhibited significant reductions in PD, Isc, and R and increases in net serosa to mucosa flux of Na and Cl (JNasm and JClsm) resulting in net Na and Cl secretion. These results suggest that Na and Cl absorption in left colon is highly efficient in young children and that mucosal inflammation may seriously impair the colon's ability to conserve salt and water.

Anus, Imperforate↗
PubMed1993

In vitro studies of sodium transport in human infant colon: the influence of acetate.

In infants, adequate colonic function is vital in preventing electrolyte and water depletion. In certain species, short-chain fatty acids have been shown to increase colonic Na absorption. Using an in vitro voltage-clamp technique, we have studied the characteristics of electrolyte transport in isolated preparations of human left-sided colonic mucosa and investigated the effect of acetate on epithelial Na movement. In the basal state, there was net Na absorption that was entirely electrogenic. The addition of mucosal acetate resulted in a significant increase in net Na absorption that was markedly inhibited by amiloride, suggesting that, in the young child, the presence of short-chain fatty acids promotes colonic salvage of Na and that such salvage of Na may be via an amiloride-sensitive Na channel and involve stimulation of sodium-hydrogen exchange.

Acetates↗
PubMed1992

Familial pancreatic enzyme insufficiency.

A father and son with profound reduction of exocrine pancreatic activity and little visible pancreatic tissue on ultrasound or computed tomography are described. Both have some degree of liver disease, which is more marked in the son. The disorder, apparently familial, does not correspond to any reported previously.

Amylases↗
PubMed1992

Salivary IgA antigliadin antibody as a marker for coeliac disease.

In recent years, serum antibodies to gliadin (AGA) have been reported to be useful markers of coeliac disease. IgA AGA have also been found in intestinal secretions and saliva in coeliac disease and may offer a convenient, non-invasive screening test. In order to test this hypothesis, salivary and serum AGA were measured in children with coeliac disease proved by biopsy and compared with several control groups. Measurement of salivary IgA AGA provided excellent discrimination between those children with coeliac disease and the control groups, and our study suggests that it may provide a rapid, non-invasive method of screening for this disease before intestinal biopsy.

Adolescent↗
PubMed1992

Management of gastroenteritis in early childhood.

The most important aspect of modern management of acute diarrhoeal illness in children is that of oral rehydration therapy, and drug therapy is very rarely indicated. Despite the dramatic decline in mortality and morbidity in recent years, there is still the need for continuing education in the appropriate use of oral rehydration solutions. The constitution of oral rehydration solutions and policies of feeding practices during illness continue to be controversial, mainly because of wide variation in the aetiology of the diarrhoea, the nutrition of the child, and the economic and public health factors involved in any particular community. The priority of all healthcare workers is to provide simple guidelines in the use of a safe oral rehydration solution while discouraging unsafe treatments.

Anti-Bacterial Agents↗
PubMed1991

The adaptive response of rectal electrolyte absorption to impaired sodium balance in young children.

Rectal electrolyte transport was measured in nine children (median age 160 days) with ileostomies, using a nonequilibrium dialysis technique. Rectal sodium absorption and potassium secretion were significantly higher in children with a subnormal sodium balance compared with children with a positive sodium balance. Rectal sodium absorption and potassium secretion were unchanged after ileostomy closure. These data indicate that rectal electrolyte transport in children can adapt to even modestly impaired sodium balance.

Child, Preschool↗
PubMed1990

Management of gastroenteritis.

Childhood gastroenteritis remains a common reason for admission to British paediatric units, although the severity of the disease appears to be diminishing in recent years. We studied 215 infants and children with gastroenteritis admitted consecutively to four paediatric units in South Wales in order to determine the severity of the disease, the organisms isolated, the frequency of complications, and the adequacy of management before admission. Stool pathogens were isolated in 125 (58%) patients (viruses in 65, bacteria in 30, and protozoa in 19, with multiple infection found in 11). There was a low incidence of morbidity and complications, but prolonged diarrhoea (postenteritis syndrome) was present in 24 (11%) cases and 77 (36%) had received inappropriate treatment before admission. Contemporary gastroenteritis is thus a relatively mild disease in the acute phase, but management before admission to hospital is often inadequate, and prolonged diarrhoea may be a feature in a considerable number of cases.

Acute Disease↗
PubMed1990

Development of colonic sodium transport in early childhood and its regulation by aldosterone.

Aldosterone is important in the regulation of sodium conservation by both kidney and colon. In the very preterm neonate marked urinary salt wasting occurs because of immature renal tubular function, but little is known of the ontogeny of colonic transport processes. Using an in vivo rectal dialysis technique, we have shown that in the human infant the colon has well developed salt conserving mechanisms from early in the last trimester of gestation and that aldosterone is an important regulatory hormone. Sodium transport mechanisms in the colon appear to develop before those in the kidney and it is possible that the colon is the major organ of sodium conservation in the preterm neonate.

Aldosterone↗