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Biomedical subjects

R G Barr

Publications and source records attributed to R G Barr.

80 records · Page 5Linked to original sources
PubMed1979

Recurrent abdominal pain of childhood due to lactose intolerance.

The role of lactose malabsorption was studied prospectively in 80 schoolchildren with recurrent abdominal pain. Malabsorption was documented in 40 per cent (16 of 59 whites, 12 of 16 blacks and four of five Hispanic children) on the basis of elevated levels of hydrogen in their breath. Those with lactose malabsorption, however, were not clinically distinguishable on the basis of past milk ingestion (P greater than 0.05), weekly pain frequency (median, five vs. six times), presence of diarrhea (40 vs. 27 per cent) or symptom response to lactose load. In children with malabsorption who completed a six-week diet trial, 70 per cent reported increased frequency of pain (P less than 0.002) when placed on their usual lactose-containing diet. Lactose malabsorption has a substantial role in the symptoms of children with recurrent abdominal pain, and it should be considered before performing invasive procedures or assuming a psychogenic origin.

Abdomen↗
PubMed1979

Chronic and occult stool retention: a clinical tool for its evaluation in school-aged children.

A scoring method was developed to assess severity of stool retention using plain abdominal radiographs. To determine whether the technique was clinically valid in identifying chronic stool retention, the method was used to evaluate films taken of children with known stool retention before and after therapy. The method showed significant statistical differences between symptomatic pre-therapy films and controls and between pre- and post-therapy films of treatment "successes." No significant differences were found between pre- and post-therapy "failures." Use of radiographs is not a substitute for careful history taking and examination, but this scoring method for evaluating stool retention can be recommended prior to more extensive, invasive investigations in children presenting with functional abdominal complaints.

Abdomen↗
PubMed1978

Sucrose malabsorption in children: noninvasive diagnosis by interval breath hydrogen determination.

To assess whether malabsorption of specific sugars is easily detected in a pediatric population by interval measurement of breath hydrogen excretion, hydrogen concentration was determined following administration of oral sucrose to six sucrose-intolerant children with congenital sucrase-isomaltase deficiency and in 16 sucrose-tolerant control subjects. Breath samples were collected by means of a newly devised nasal prong technique not requiring active patient cooperation and suitable for use in all age groups. Breath hydrogen concentrations obtained by samples collected by this method correlated highly (r = 0.94) with the previously validated modified Haldane-Priestley tube method for sampling alveolar air. Identification of sucrose-intolerant individuals was achieved on the basis of hydrogen excretion: peak values, expressed as parts per million above baseline (deltappm), equalled 114 +/- 63 (mean +/- SD) versus 2.4 +/- 3.6 deltappm in control subjects (P = 0.007). Best discrimination between the groups occurred at 90 minutes postingestion. The findings validate this simple method for collection of expired air and demonstrate that breath hydrogen determination permits the noninvasive detection of sucrose malabsorption in children.

Adolescent↗
PubMedDate not supplied

A one-hour active coping stressor reduces small bowel transit time in healthy young adults.

OBJECTIVE: To examine the effect of a prolonged active coping stressor on the transit of a substance from the mouth through small intestine in normal human volunteers. METHOD: Twelve healthy undergraduate males were administered 10 g of the nonabsorbable carbohydrate lactulose in two experimental sessions. In normal individuals, lactulose produces hydrogen gas upon exposure to bacteria residing in the colon. Repeated measurements of breath hydrogen were obtained for 2 hours. In one session, subjects rested quietly for the 2-hour period. In the other counterbalanced session, subjects avoided mild electric shocks by playing videogames for the first hour. RESULTS: Stress produced a statistically and clinically significant reduction in mean transit time, from 79 to 55 minutes. The magnitude of stress-induced reduction in small bowel transit time was significantly correlated with change in an index of cardiac sympathetic activity, pulse transit time. CONCLUSIONS: A prolonged active coping stressor with minimal motor requirements produced a decrease in small bowel transit time comparable with that observed in several studies of the effects of physical exercise and in comparisons between normal controls and patients with diarrhea-predominant irritable bowel syndrome.

Adaptation, Psychological↗
PubMedDate not supplied

Behavioral and physiological responsivity, sleep, and patterns of daily cortisol production in infants with and without colic.

To describe the behavioral and physiological responses associated with colic, the responses of 20 two-month-old infants with and 20 without colic were studied during a physical examination. Parents kept a diary of infant behaviors (including crying and fussing) for 3 days following the visit. Using Wessel, Cobb, Jackson, Harris, & Detwiler criteria, colic was defined as fussing/crying for 3 hr or more on each of the 3 days. Behavioral data coded by "blind" observers showed that during the physical exam, colic infants cried twice as much, cried more intensely, and were more inconsolable than were control infants. Despite these behavioral differences, heart rate, vagal tone, and cortisol measures indicated no appreciable difference in physiological responsivity for the two groups. At home, parents collected saliva cortisol samples at wakeup, midmorning, midafternoon, and evening for 2 days. In a finding similar to that shown by the laboratory data, the colic and control infants did not have different levels of daily average cortisol. These laboratory and home data provide no evidence of greater responsivity in the physiological substrate of difficult temperament for colic infants and are consistent with evidence of similarity in temperament once colic is resolved. At home, compared with control infants, colic infants did display a blunted rhythm in cortisol production. By diary, they also slept about 2 hr less per day than did control infants. Nighttime sleep was still significantly different when fussing/crying was statistically controlled. These data suggest that colic might be associated with a disruption or delay in the establishment of the circadian rhythm in activity of the hypothalamic-pituitary-adrenocortical axis and associated sleep-wake activity.

Analysis of Variance↗