Search PubMed⌕ Search

Biomedical subjects

J F Fitzgerald

Publications and source records attributed to J F Fitzgerald.

At least 91 records · Page 5Linked to original sources
PubMed1986

Dietary fructose in the management of intractable diarrhea of infancy.

Carbohydrate digestion/absorption was evaluated in 11 infants with intractable diarrhea while they were receiving a carbohydrate-free soy-isolate formula. Seven patients were fed within 48 h of admission. Enteral feedings were initiated in the remainder after they had gained 1 kg while receiving parenteral nutrition. All feedings were initially administered by continuous nasogastric infusion. Nine patients were initially fed formula with polymeric glucose; two received fructose as the carbohydrate source, based on a documented history of polymeric glucose intolerance. Five of the nine developed watery, acidic stools while receiving polymeric glucose. All were switched to fructose, which resulted in improvement in stool pH and consistency. Glucose tolerance was normal 1 month after discharge in all seven fructose-requiring infants. Three of six infants have shown a persistent inability to hydrolyze sucrose. Several putative mechanisms of polymeric glucose intolerance are discussed, as well as the apparent association with primary sucrase-isomaltase deficiency in three of the patients. Fructose is an effective alternative carbohydrate source in infants unable to tolerate polymeric glucose, and early initiation of fructose may obviate the need for total parenteral nutrition and prolonged bowel rest.

Diarrhea, Infantile↗
PubMed1986

Specialized formulas and feedings for infants with malabsorption or formula intolerance.

The composition of specialized formulas for infants who experience malabsorption or formula intolerance is described in detail. The limited studies of efficacy, as well as a rationale for selecting an appropriate formula for infants with malabsorption or formula intolerance, are discussed. Infants with symptoms of diarrhea or emesis may have intolerance to milk lactose or milk protein. Soy formulas contain no lactose or cow's milk and should be the first choice of an alternative feeding because of cost and convenience. Some infants may be intolerant of soy as well as cow's milk protein. They benefit from formula containing neither cow's milk nor soy protein or from a specially processed milk-based formula containing hydrolyzed casein. A carbohydrate-free formula to which the desired type of carbohydrate is added may be helpful in the diagnosis and treatment of disaccharidase deficiencies and monosaccharide intolerances. Infants with extensive intestinal resections or intractable diarrhea may require specialized infant formulas with qualitative/quantitative modifications of fat, carbohydrate, and protein. Formulas with medium-chain triglycerides may be useful for infants with steatorrhea. "Preterm" formulas or milk from the infant's mother are preferred for preterm infants, since such feedings promote improved fat and carbohydrate absorption and better meet the infant's nutrient requirements.

Animals↗
PubMed1985

Vitamin E sufficiency in children with cholestasis: a comparison between erythrocyte peroxide hemolysis and serum alpha-tocopherol.

Vitamin E sufficiency was assessed in 19 children with chronic cholestasis by determining both erythrocyte peroxide hemolysis (EPH) and serum alpha-tocopherol (alpha-T) levels. Eight had normal alpha-T (1.19 +/- 0.67 mg/dl; normal greater than 0.5). The mean EPH in this group was 13.1 +/- 14.3% (normal less than 20%). The remaining 11 patients had low alpha-T levels (0.25 +/- 0.15 mg/dl) and elevated EPH (83.9 +/- 17.1%). Children found to be vitamin E deficient received either oral alpha-T (50-100 IU/kg per day) or parenteral alpha-tocopherol acetate in sesame oil every 2-4 wk (200-300 mg). This permitted serial monitoring of EPH and alpha-T. We found that normalization of the EPH was uniformly accompanied by normalization of the alpha-T level. However, normal alpha-T levels occurred with elevated EPH (between 20% and 80%) on 11 occasions. EPH greater than 80% correctly identified vitamin E deficiency in all cases. Hence, EPH is a satisfactory screening test of vitamin E sufficiently. When the EPH is less than 20%, the patient is vitamin E sufficient. Conversely, when the EPH is greater than 80%, the patient is vitamin E deficient. Serum alpha-T measurements are needed to determine vitamin E sufficiency when the EPH is greater than 20% and less than 80%.

Adolescent↗
PubMed1985

Confirmation of serum salicylate levels in Reye's syndrome: a comparison between the Natelson colorimetric method and high performance liquid chromatography.

Serum was obtained from 11 patients with Reye's syndrome at admission and analyzed for the presence of salicylates by the Natelson colorimetric technique and high performance liquid chromatography. Salicylate levels obtained by the Natelson method had a mean of 6.00 mg/dl +/- 4.58; the mean HPLC salicylic acid level was 5.09 mg/dl +/- 5.14. The correlation coefficient was 0.985 with a linear regression line y = 0.8788x + 1.527. No other salicylate metabolites nor interfering substances were identified. Once the accuracy of the Natelson method was confirmed, the charts of 82 patients were reviewed for admission salicylate levels. The overall mean was 8.63 mg/dl (survivors, 8.45 mg/dl +/- 8.56; fatalities, 9.28 mg/dl +/- 5.34). There was no correlation found between admission salicylate level and peak ammonia level, another important index of disease severity.

Ammonia↗
PubMed1985

Hemorrhagic complications of Henoch-Schönlein syndrome.

Two patients are described with atypical manifestations of Henoch-Schönlein syndrome. One patient suffered severe intracranial hemorrhage and a subsequent massive gastric hemorrhage. The other patient developed an asymptomatic serosanguinous pleural effusion. Both had evidence of profound hypoprothrombinemia at the time of admission. Aggressive management of any coagulopathy accompanying Henoch-Schönlein syndrome is cardinal in order to prevent life-threatening complications such as gastrointestinal, intracranial, and pulmonary hemorrhage.

Cerebral Hemorrhage↗
PubMed1985

Nephrolithiasis in childhood inflammatory bowel disease.

Six children with inflammatory bowel disease and nephrolithiasis are reported. Their mean age at the passage of the first stone was 12.5 years and the mean duration of active inflammatory bowel disease was 34.5 months. Four had ulcerative colitis and two had Crohn's disease. In three patients, the onset of stone disease was associated with a flare in the bowel disease. Stone passage in four patients was accompanied by an increase in abdominal pain; three experienced gross hematuria. Stones from four of the patients were composed primarily of calcium phosphate; stones from the remaining patients contained uric acid and/or calcium oxalate. The pathogenesis of nephrolithiasis as it relates to inflammatory bowel disease is considered and an approach to therapy offered.

Adolescent↗
PubMed1984

Chronic hepatitis.

Explore the source record for details and available documents.

Autoimmune Diseases↗
PubMed1984

Spontaneous bacterial peritonitis.

Spontaneous bacterial peritonitis should be considered in the evaluation of any patient with acute abdominal complaints, especially in the presence of preexistent ascites. Paracentesis is indicated in all suspected cases of spontaneous peritonitis in order to obtain necessary studies, including microbial cultures. Broad-spectrum antibiotic coverage has become necessary because of the increasing incidence of gram-negative isolates. Ascitic pH and lactate may provide accurate information in the evaluation of spontaneous peritonitis, although increased clinical awareness remains the key to proper diagnosis.

Adult↗
PubMed1984

Effect of exogenous corticosteroid therapy on growth in children with HBsAg-negative chronic aggressive hepatitis.

The effect of exogenous corticosteroid therapy on growth was studied in 12 patients with HBsAg-negative chronic aggressive hepatitis. All patients were less than 13 years of age at diagnosis and were free of cirrhosis. The patients' growth records were retrospectively reviewed for incremental growth changes while they were receiving daily prednisone and alternate-day prednisone, as well as for 1 year after the cessation of therapy. These values were compared with age-matched growth velocities in normal children. Daily steroid therapy was associated with a reduction in growth velocity (p less than 0.01). There was an acceleration in growth velocity during the period of alternate-day therapy, compared with predicted values (p less than 0.03), which persisted during the 1st year after therapy was discontinued (p less than 0.02). Nine of 12 patients crossed growth percentiles during steroid therapy. We have confirmed that daily steroid administration is associated with a reduction in linear growth, while alternate-day therapy has an apparent positive effect on growth, presumably through control of the underlying disease. The mechanism of this supranormal growth rate is unclear.

Body Height↗