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Biomedical subjects

S N Peck

Publications and source records attributed to S N Peck.

5 recordsLinked to original sources
PubMed1997

Vertebral compression fractures in pediatric patients with Crohn's disease.

Osteoporosis is known to be a significant complication of Crohn's disease in adult patients. The association of osteoporosis and the development of vertebral compression fractures is well delineated. This case report describes 5 pediatric patients with Crohn's disease in whom vertebral compression fractures associated with a marked reduction in bone density developed. As in adults, the association of osteoporosis and Crohn's disease in pediatric patients is multifactorial, including corticosteroid use, calcium and vitamin D homeostasis, malnutrition, alteration in sex hormones, and site of disease. At the time of diagnosis of the vertebral fractures, the patients' ages ranged from 10.6 to 16.8 years, they had persistent and severe back pain, and 3 of 5 patients had a decrease in height. They were taking 13.7-41.6 mg/day of corticosteroid, and all 5 patients had terminal ileal involvement. Bone mineral density measured by dual-energy x-ray absorptiometry was well below 2SD from the mean in all patients (z-score, -2.31 to -5.11). Because of the high morbidity and mortality associated with fractures that result from low bone mineral density, medical care of all pediatric patients with Crohn's disease should include an evaluation of bone mineral density.

Adolescent↗
PubMed1992

Pseudo-obstruction in children.

Pseudo-obstruction of the gastrointestinal tract is a rare disorder of impaired gastrointestinal motility. The more common symptoms of pseudo-obstruction in the infant or child include dysphagia, nausea, vomiting, abdominal distention, abdominal pain, and constipation. The majority of children have symptoms within the first year of life. Chronic cases of pseudo-obstruction are associated with neuropathic or myopathic changes in other parts of the body. Bladder dysfunction and neurological problems have been reported. The diagnosis of pseudo-obstruction is based on history, physical examination, radiographic studies and motility studies. Advances in medical technology have facilitated the identification of abnormal motility patterns in children. Therapy for pseudo-obstruction is primarily supportive. The use of motility agents has been unsuccessful in treating pseudo-obstruction. Nutritional and antibiotic therapy are the mainstays of treatment. Nursing interventions, patient/family education and advances in home care technology have improved the quality of life for children with pseudo-obstruction. Small bowel transplantation offers hope for the future.

Child, Preschool↗
PubMedDate not supplied

Bowel preparation before colonoscopy in the pediatric patient: a randomized study.

Flexible fiberoptic colonoscopy is an established diagnostic procedure in the pediatric patient. The approach to the pediatric patient is, however, different from the approach to adults. Bowel preparation must be geared to the age, size, and clinical status of the patient. An effective, palatable, standardized bowel preparation has not been determined for the child undergoing a colonoscopy. This study systematically evaluated three components of the bowel preparation--cathartics, diet, and enema use. The bowel preparation of 140 children undergoing colonoscopy at The Children's Hospital of Philadelphia was evaluated. The effectiveness of the bowel preparation was evaluated by direct visualization during the colonoscopy as to the amount and consistency of the residual stool in the colon. Parents were interviewed to determine adherence to the instructions including tolerance of diet, cathartics, and enema administration. Equipment maintenance was also monitored. An effective bowel preparation was achieved in all groups. As a result of this study, the Division of Gastroenterology and Nutrition at The Children's Hospital of Philadelphia now uses a less restrictive diet, one enema, and X-Prep to achieve effective bowel preparation for colonoscopy.

Adult↗