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Biomedical subjects

J L Sutphen

Publications and source records attributed to J L Sutphen.

29 records · Page 2Linked to original sources
PubMed1986

Antacid and formula effects on gastric acidity in infants with gastroesophageal reflux.

A variety of peptic diseases are treated with antacids. Antacid dose requirements for young children have not been extensively evaluated. Moreover, the effects of formula feedings on antacid requirements are also unknown. We have investigated the effects of antacids and formula feedings on gastric acidity in infants less than 1 year of age. Small formula feedings of 15 mL/kg per feeding significantly improve antacid buffering of 0.5 mL/kg per dose of standard magnesium-aluminum hydroxide antacids.

Aluminum Hydroxide↗
PubMed1985

Growth as a measure of nutritional status.

Growth data have been used as a measure of nutritional status and disease activity in children. This review discusses common anthropometric techniques and emphasizes the inference of nutritional status from these measurements. As multiple factors influence growth, it is often difficult to isolate the effects of nutrition alone.

Adolescent↗
PubMed1985

Desquamative interstitial pneumonitis complicating inflammatory bowel disease of childhood.

Sulfasalazine has been associated with bronchopulmonary complications of inflammatory bowel disease (IBD) in adults. We describe a 12-year-old boy who developed desquamative interstitial pneumonitis and hepatic cirrhosis several years following the onset of ulcerative colitis. The restrictive lung disease progressed despite cessation of sulfasalazine and initiation of corticosteroid therapy. We discuss a variety of bronchopulmonary complications of IBD and their association with sulfasalazine.

Adolescent↗
PubMed1984

Metastatic cutaneous Crohn's disease.

A 16-yr-old boy and a 38-yr-old woman with Crohn's disease developed granulomatous dermatitis on the forearm and lower calf, respectively. Their lesions were clinically and histologically similar to those described in the small number of prior reports of "metastatic" cutaneous Crohn's disease. They were readily distinguished from those of other dermatologic conditions associated with Crohn's disease, such as pyoderma gangrenosum, erythema nodosum, and cutaneous polyarteritis nodosa. Appropriate clinical studies, biopsy specimens, and cultures are required, however, to exclude other forms of granulomatous disease that could occur coincidentally in a patient with Crohn's disease.

Adolescent↗
PubMed1983

Chronic diarrhea associated with Clostridium difficile in children.

Clostridium difficile toxin was associated with chronic diarrhea without classic symptoms of colitis in seven children (age range, 7 weeks to 7 years). All patients had received antibiotics. Six of the seven were treated with vancomycin hydrochloride and demonstrated improvement. After treatment, four patients suffered relapses, and three required further therapy. One patient had four relapses. During all clinical relapses, toxin reappeared in the stool; recovery was always associated with its disappearance. Fifty-six percent of family contacts examined had positive cultures. These findings document C difficile as a probable cause of chronic diarrhea in childhood and emphasize its infectious potential.

Bacterial Toxins↗
PubMed1982

Anthropometric determinants of creatinine excretion in preterm infants.

Creatinine output per unit of body weight increases throughout childhood. this reflects the increase in percent muscle mass observed during growth. Standard values for creatinine excretion are not available for the preterm infant. Accordingly, urinary creatinine output was measured in timed 24-hour specimens obtained in the second week of life of 15 preterm infants (gestational age 26 to 33 weeks). Three highly significant regression equations were derived that relate creatinine excretion to birth weight, length, and gestational age. Creatinine output correlated best with birth weight. Stepwise regression yielded no linear combination of these variables that improved the estimate based on weight alone. In a similar manner, consideration of other variables, including weight and length for age (expressed as percent of 50th percentile), did not improve the estimate based on weight alone. These data demonstrate that creatinine output in milligrams per kilogram of body weight increases by 16% between birth weight of 0.7 and 1.5 kg. This increase parallels that in body protein content per kilogram obtained from published fetal body composition data in infants of similar age. Creatinine output in preterm infants, therefore, can serve as a measure of growth.

Anthropometry↗
PubMedDate not supplied

The immature intestine: implications for nutrition of the neonate.

The survival and prognosis of the prematurely born human infant are dependent on a successful transition from the intrauterine to the extrauterine environment. This is largely a consequence of the maturation of sufficient gastrointestinal function to provide adequate nutrition. However, the gastrointestinal tract of the premature infant, and to some extent, of the full-term infant, may be unprepared to provide the requisite absorptive function. Data presented in this symposium emphasize the dissociations in the development of human gastrointestinal function. Morphological maturation is completed early in gestation while glucose absorption increases with gestational age. Sucrase and maltase activities appear early; lactase activity begins to increase at 30 weeks and increases steadily to term. The latter pattern is accompanied by increased production of cortisol and thyroid in the fetus. The intraluminal phase of fat digestion is immature even in the full-term neonate. Both pancreatic secretory function and bile salt metabolism mature postnatally. Despite this relative immaturity, breast milk fat is absorbed with great efficiency by the term infant, and breast milk provides other important influences on intestinal development: mitogenic factor, immunological support, control of intestinal flora. The goals of nutrition support of the premature infant have been to maintain intrauterine growth standards; yet premature infants receiving pooled breast milk from mothers at 40 weeks or more may be given too little protein for their needs. Human milk from mothers of premature infants may be a more appropriate nutrient source. Supplements with higher contents of amino acids may lead to amino acid imbalance or hyperammonaemia. Additional stresses and requirements are imposed by illness or congenital anomalies. While we must apply current research findings to clinical care, we must also extend our knowledge of extrauterine human development. The ultimate measure of success in this field will be the physical and neurological capacities of infants followed prospectively.

Aging↗
PubMedDate not supplied

Effect of feeding volume on early postcibal gastroesophageal reflux in infants.

Using esophageal pH monitoring, we have investigated the effect of feeding volume on early (1 h) postcibal gastroesophageal reflux (GER) in a population of 50 infants referred for evaluation. Two feedings with the volume of both feedings specified (9 and 18 ml/kg) were given to one group of infants. A second group was given one feeding ad libitum and another specified at 9 ml/kg. Volume of intake was a very significant determinant of both the total duration and the maximum single continuous episode of GER during early postcibal esophageal pH monitoring in both groups by paired analyses. This effect was observed in infants with significant GER (n = 44) and in a subgroup of infants who were normal (n = 6).

Eating↗
PubMedDate not supplied

Chronic gastroenteritis in a patient with histiocytosis-X.

We describe a 5-year-old white girl who presented at 18 months of age with an ileal perforation and radiographic evidence of segmental intestinal narrowing. Her initial diagnosis was Crohn's disease; however, on subsequent microscopic review, her lesion consisted of mixed histiocytic and eosinophilic infiltration characteristic of histiocytosis-X. The case is unique in its clinical similarity to Crohn's disease and its paucity of extraintestinal manifestations in the face of persistent mild chronic intestinal symptoms. She remains well controlled on prednisone therapy.

Biopsy↗
PubMedDate not supplied

Alteration of normal gastric flora in neonates receiving ranitidine.

OBJECTIVES: To determine if the administration of ranitidine to neonates leads to an increase in gastric pH to > or = 4 and if this increase in gastric pH correlates with gastric colonization. STUDY DESIGN: 628 pH measurements and 276 gastric cultures were obtained from 86 neonates. Twenty-three patients received ranitidine and 63 patients served as controls. RESULTS: Treated patients had a mean gastric pH of 5.6 compared with a control mean pH of 4.4 (p < 0.0001). Gastric pH was significantly affected by feeding and postnatal age. 54 patients were colonized with pathogenic bacteria and/or yeast (n = 20 treated, n = 34 control). Length of hospitalization (p < 0.0001), increase in gastric pH (p < 0.01), days of antibiotics before culture (p < 0.0001), and ranitidine use (p < 0.0001) were associated with an increased rate of colonization. CONCLUSIONS: The use of ranitidine did lead to a significant increase in gastric pH and with this increase in gastric pH gastric colonization rates increased. No increased frequency of infection was found in ranitidine-treated infants.

Anti-Bacterial Agents↗