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PubMed2006

Risk factors for colic in horses after general anaesthesia for MRI or nonabdominal surgery: absence of evidence of effect from perianaesthetic morphine.

REASON FOR PERFORMING STUDY: Post anaesthetic colic is a recognised risk of general anaesthesia (GA), but causes are poorly understood. OBJECTIVES: To identify risk factors for development of colic following GA for magnetic resonance imaging (MRI) or nonabdominal surgery and to test whether the use of perianaesthetic morphine was associated with an increased risk of post anaesthetic colic. METHODS: A total of 553 anaesthetic and clinical records of 500 horses anaesthetised at the Animal Health Trust were analysed, 342 (62%) involved MRI and 211 (38%) nonabdominal, predominantly orthopaedic surgery. Multivariable logistic regression analysis was used to examine the association between post anaesthetic colic and explanatory variables, including use of perianaesthetic morphine. RESULTS: Twenty horses (3.6%) developed colic within 7 days of GA. A significantly larger (P = 0.001) proportion of the surgical cases developed post anaesthetic colic (7.1%) compared with MRI cases (1.5%). Having controlled for the effect of MRI/surgeon, there was evidence for a significantly increased risk of colic associated with maintenance of anaesthesia with isoflurane and administration of benzyl penicillin and/or ceftiofur. A reduction in risk of colic was associated with premedication with romifidine, longer duration of anaesthesia and sedation within 2 days of GA. Perianaesthetic morphine administration was not associated with increased risk. CONCLUSIONS: This study identified apparently novel risk factors for colic in horses following GA. Use of morphine was not found, after controlling for other MRI and surgery related risk factors, to be associated with an increased risk. The low prevalence of colic after GA and resulting low study power mean that further larger, multicentre collaborative studies are warranted to corroborate findings in this study. POTENTIAL RELEVANCE: Better knowledge of risk factors should lead to achievable measures to reduce frequency of occurrence.

Anesthesia, General↗
PubMed2006

[Surgical anatomy of the colic vessels in Chinese and its influence on the operation of esophageal replacement with colon].

OBJECTIVE: To investigate the configuration of colic vessels in Chinese and its influence on the operation of esophageal replacement with colon (ERC). METHODS: The origin, trend, branching, configuration, and distribution of the colic vessels, the intensity of the colic arterial impulse, the integrity of the marginal artery at the splenic flexure and hepatic flexure of colon were observed during the operation of ERC among 582 patients undergoing ERC, 402 males mad 180 females, aged 2 approximately 74, from 22 provinces, municipality, and autonomous regions. RESULTS: The left colic artery (LCA) stemmed from the inferior mesenteric artery (IMA) in 97.3% of the patients, with an absence rate of 0.7%. The middle colic artery (MCA) stemmed from the superior mesenteric artery (SMA) in 77.8% of the patients with an absence rate of 8.2%. Accessory middle colic artery (acMCA), originating from the right colic artery, could be seen in 6.2% of the patients 39.7% of the right colic artery (RCA) stemmed from the SMA by itself, 23.0% of the RMA stemmed together with MCA, and 28.0% of the RCA stemmed together with the ileocolic artery. The absence rate of RCA was 9.8%. The intactness rate of marginal artery was 96.8% at the splenic flexure of colon, and was 88.7% at the hepatic flexure. The Rolan arch was seen in only 7.6% of the patients. CONCLUSION: The configuration of colic vessels in Chinese was basically similar to those of the results of autopsies carried out abroad. The optimal supply artery of colic segment during ERC is LCA, followed by LCA. Attention should be paid to the integrity of marginal arteries and veins in the patients with history of epigastric operation.

Adolescent↗
PubMed1981

Infantile colic and near-miss sudden infant death syndrome.

Frequent awakenings occur in infantile colic acid sleep-related respiratory control disorders. To evaluate the possibility that colic may be associated with impaired respiratory control, prevalence and clinical features of colic among infants who died from Sudden Infant Death Syndrome (SIDS), infants with a clinical diagnosis of Near-Miss Sudden Infant Death Syndrome (N-M SIDS), and a control group were retrospectively determined. Colic did not occur in any of the 17 infants in the control group who had normal ventilatory responses. Colic did occur in 14 (33%) of 42 infants with N-M SIDS who had impaired ventilatory responses. Ventilatory responses among the N-M SIDS infants were similar in those with and without colic. Four (27%) of the 15 SIDS victims had colic, but the spells had disappeared before their deaths. The proportion of infants with colic among the N-M SIDS infants is significantly greater than among control infants (p less than 0.05). In summary, colic related night wakings may represent an alternative and protective behavioral arousal mechanism in N-M SIDS infants, a group in which a variety of sleep-related respiratory control deficits have previously been documented.

Colic↗
PubMed1998

The effect of infant colic on maternal self-perceptions and mother-infant attachment.

Mothers of infants who developed colic were compared with mothers of non-colic infants on their perceptions of parenting self-efficacy, and separation anxiety as well as their attachment relationship with their infants. Colic was identified prospectively through telephone contacts with mothers. Questionnaires on self-efficacy and separation anxiety were completed when infants were 5 months of age. At 18 months of age mothers and infants (colic and non-colic) participated in a laboratory situation to measure attachment. Results revealed that mothers of colic infants reported feeling less competent as mothers. In addition, while mothers of colicky infants tended to have more separation anxiety than mothers of non-colic infants, they felt that these separations did not have a negative effect on their child. Finally, no differences were revealed for attachment classifications between colic and non-colic infants at 18 months.

Adolescent↗
PubMed2003

Changes in coagulation and markers of fibrinolysis in horses undergoing colic surgery.

Activation of coagulation can be frequently found in horses with colic. However, it has also been demonstrated as a sequela of surgical trauma alone in humans. The purpose of the present study was to determine changes in coagulation and fibrinolysis in horses that underwent colic surgery and to evaluate whether these changes were secondary to the colic or the surgery and wound healing. Thirty horses that underwent colic surgery with uncomplicated recovery were included. Ten horses with a Forssell's procedure served as control group with a standardized surgical trauma. Besides daily physical examinations during the observation period of 10 days, activated partial thromboplastin time (aPTT), prothrombin time and thrombin time as well as fibrin monomer (FM), D-Dimer (DD) and antithrombin (AT) III were determined. Compared with the control group the aPTT was the only standard coagulation test that was significantly prolonged before and after the event of colic surgery. After surgery, hyperfibrinogenaemia occurred in all groups. In colic groups FM and DD concentrations were within reference range at admission,and were significantly greater than in control horses after surgery. AT III activity decreased after colic surgery, but did not change in the control group. It was concluded that an activated coagulation state after colic surgery has to be expected, resulting not only from the colic disease, but also from the event of surgery.

Animals↗
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↗
PubMed2004

Infant colic and feeding difficulties.

AIMS: To examine the relation between colic and feeding difficulties and their impact on parental functioning for a primarily clinic referred sample. METHODS: Forty three infants (and their mothers) were enrolled between 6 and 8 weeks of age. Infants were divided into two groups, colic (n = 19) and comparison (n = 24), based on a modified Wessel rule of three criteria for colic. Families were assessed at two visits; one occurred in the laboratory and one occurred in a paediatric radiology office. Outcome measures included the clinical assessment of infant oral motor skills, behavioural observation of mother-infant feeding interactions, maternal questionnaires on infant crying, sleeping and feeding behaviours, and the occurrence of gastro-oesophageal reflux (GOR) in the infants using abdominal ultrasound. RESULTS: Infants in the colic group displayed more difficulties with feeding; including disorganised feeding behaviours, less rhythmic nutritive and non-nutritive sucking, more discomfort following feedings, and lower responsiveness during feeding interactions. Infants in the colic group also had more evidence of GOR based on the number of reflux episodes on abdominal ultrasound as well as maternal report of reflux. Mothers in the colic group reported higher levels of parenting stress. CONCLUSIONS: Results provide the first systematic evidence of feeding problems in a subgroup of infants with colic. Data also illustrate the impact of these difficulties on parental and infant functioning. The association between feeding difficulties and colic suggests the potential for ongoing regulatory problems in infants presenting with clinically significant colic symptoms.

Adult↗
PubMed1999

What is distinct about infants' "colic" cries?

AIMS: To investigate (1) whether colic cries are acoustically distinct from pre-feed "hunger" cries; (2) the role of the acoustic properties of these cries versus their other properties in accounting for parents' concerns about colic. DESIGN: From a community sample, infants were selected who met Wessel colic criteria for amounts of crying and whose mothers identified colic bouts. Using acoustic analyses, the most intense segments of nine colic bouts were compared with matched segments from pre-feed cries presumed to reflect hunger. RESULTS: The colic cries did not have a higher pitch or proportion of dysphonation than the pre-feed cries. They did contain more frequent shorter utterances, but these resembled normal cries investigated in other studies. There is no evidence that colic cries have distinct acoustic features that are reproducible across samples and studies, which identify a discrete clinical condition, and which are identified accurately by parents. CONCLUSIONS: The most reliable finding is that colic cries convey diffuse acoustic and audible information that a baby is highly aroused or distressed. Non-acoustic features, including the prolonged, hard to soothe, and unexplained nature of the cries may be specific to colic cries and more important for parents. These properties might reflect temperament-like dispositions.

Acoustics↗
PubMed2003

Evaluation of activated neutrophils in the blood of horses with colic.

OBJECTIVE: To evaluate the activation status of neutrophils in blood samples obtained from horses with naturally occurring colic associated with strangulating obstruction, nonstrangulating obstruction, or inflammatory bowel disease. ANIMALS: 30 horses with naturally occurring colic and 30 healthy control horses. PROCEDURE: Activation status of neutrophils was determined by assessing the number of neutrophils that could pass through filters with 5-microm pores, cell-surface CD11-CD18 expression, and alterations in size and granularity of neutrophils. RESULTS: Horses with impaction or gas colic did not have evidence of activated neutrophils. Horses with inflammatory bowel disease consistently had evidence of activated neutrophils, including decreased leukocyte deformability, increased CD11-CD18 expression, increased neutrophil size, and decreased neutrophil granularity. Horses with strangulating colic had variable results. Of horses with strangulating colic, 7 of 14 had marked changes in filtration pressures, 5 of 14 had increased CD11-CD18 expression, 6 of 14 had changes in neutrophil size, and 5 of 14 had changes in neutrophil granularity. Among horses with strangulating colic, changes in deformability, size, and granularity of neutrophils correlated with an adverse outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Activated neutrophils were detected in all horses with inflammatory bowel disease and a few horses with strangulating colic. Correlation of activated neutrophils with horses that had strangulating colic that died or were euthanatized indicates that activated neutrophils are a negative prognostic indicator. Additional studies are needed to determine whether activated neutrophils contribute directly to the adverse outcome in horses with strangulating colic.

Animals↗
PubMed1999

Prevalence of Clostridium perfringens enterotoxin and Clostridium difficile toxin A in feces of horses with diarrhea and colic.

OBJECTIVE: To determine prevalence of clostridial enterotoxins in feces of horses with diarrhea and colic, and to determine whether an association exists between detection of clostridial enterotoxins in feces and development of diarrhea as a complication of colic. DESIGN: Prospective case series and case-control study. ANIMALS: 174 horses with diarrhea, colic, or problems not related to the gastrointestinal tract. PROCEDURE: Horses were assigned to 1 of 4 groups: colic with diarrhea (group 1; n = 30); colic without diarrhea (group 2; 30); diarrhea without colic (group 3; 57); and control (group 4; 57). Feces were evaluated by use of ELISA to detect Clostridium perfringens enterotoxin (CPE) and C difficile toxin A (TOXA). Frequency of detection of CPE or TOXA in groups 1 and 3 was compared with that in groups 2 and 4, respectively. RESULTS: Prevalence of enteric clostridiosis in horses in group 3 was 25%. Clostridium perfringens enterotoxin was detected in 9 of 57 (16%), TOXA in 8 of 57 (14%), and both toxins in 3 of 57 (5%) fecal samples collected from these horses. Neither toxin was detected in feces of the age-matched horses in group 4. Clostridial enterotoxins were detected in feces of 7 of 60 (12%) horses with colic (groups 1 and 2), however, a significant association was not found between detection of enterotoxins in feces and development of diarrhea as a complication of colic. CONCLUSIONS AND CLINICAL RELEVANCE: Clostridia are important etiologic agents of diarrhea in horses. Additionally, changes in intestinal flora of horses with colic may allow for proliferation of clostridia and elaboration of enterotoxins regardless of whether diarrhea develops.

Animals↗
PubMed2003

[Evaluation of non-enhanced spiral CT in the assessment of renal colic: prospective series of 81 patients].

OBJECTIVE: For many years, intravenous urography has been the first-line investigation for renal colic. Since the middle of the 1990s, non-enhanced spiral CT has become a more efficient, less invasive and less expensive alternative to IVU. The aim of this study was to compare non-enhanced spiral CT and IVU in the assessment of renal colic and to evaluate the possibility of exclusive CT assessment in this disease. MATERIAL AND METHODS: Prospective study including 81 patients all undergoing urgent non-enhanced spiral CT, while the first 30 patients were investigated by non-enhanced spiral CT and IVU. RESULTS: Comparison of IVU versus CT: better sensitivity of CT for the diagnosis of renal colic (96% vs 92%) and for the detection of stones (95% vs 59%). CT diagnosis: A definitive diagnosis of renal colic was established in 72/81 patients: stone visualized in 64 cases and post colic syndrome in 8 cases, while the other 9 patients presented a non-urological abdominal disease. DISCUSSION: Comparison of our series with results reported in the literature confirms the superiority of CT over IVU with better visualization of the stone at a lower cost, with a shorter examination time, without injection and allowing the detection of non-urological disease. Analysis of CT signs emphasizes the importance of secondary signs for the diagnosis of renal colic (dilatation, perirenal or ureteric oedema, rim sign). Delayed excretion demonstrated by IVU and not directly evaluable by non-enhanced CT is no longer an argument in favour of IVU as first-line examination for the assessment of renal colic. CONCLUSION: The superiority of CT for the diagnosis of renal colic has now been demonstrated. Renal colic can now be assessed exclusively by first-line non-enhanced helical CT. IVU or contrast-enhanced CT may be indicated in rare cases when there is a doubt about the diagnosis on non-enhanced CT.

Adult↗
PubMed1996

[Echographic and ERCP-manometric study of gallbladder and Oddi's sphincter behavior in biliary colic in patients with cholelithiasis. Effects of cerulein].

In a previous study, we have shown that caerulein relieves biliary colic pain in gallstone patients. This study was initiated to determine gallbladder and sphincter of Oddi behaviour during biliary colic and their response to caerulein. In 10 gallstone patients gallbladder volume was measured by real-time ultrasonography during a biliary colic episode and 72 hours after cessation of pain, before and after caerulein administration. Basal sphincter of Oddi pressure was determined by CPRE manometry in 10 gallstone patients during biliary colic and three days after cessation of pain, before and after caerulein. The results of this study show that, during biliary colic, gallbladder volume is 8 times greater than in the post-colic state. Basal sphincter of Oddi pressure was also significantly higher during biliary colic than in the post-colic state. Caerulein relieved in all cases the biliary colic pain while reducing gallbladder volume and decreasing the sphincter of Oddi.

Adult↗
PubMed2002

Sequelae of infant colic: evidence of transient infant distress and absence of lasting effects on maternal mental health.

BACKGROUND: Colic is widely believed to remit by 3 months of age, with little lasting effect on the infant or the family. OBJECTIVES: To determine the prevalence of colic at 3 months and the proportion of cases of colic (identified at 6 weeks) that remitted by 3 months; to identify the factors predictive of colic's remission; and to explore the potential lasting effects of colic on maternal mental health. DESIGN: Prospective cohort study of 856 mother-infant dyads. Self-administered questionnaires were mailed to mothers at 1 and 6 weeks and 3 and 6 months post partum. Standardized instruments were incorporated into the first and last questionnaires to assess maternal anxiety, postnatal depression, and social support. At 6 weeks and at 3 months, mothers completed the Barr diary and/or the Ames Cry Score. RESULTS: Data from 547 dyads were available for analysis. The prevalence of colic at 3 months was 6.4%. More than 85% of cases of colic had remitted by 3 months of age. These infants were more likely to be female, whereas the mothers of these infants were more likely to have received pain relief during labor/delivery and to have been employed during pregnancy. Reductions in scores for trait anxiety and postnatal depression, although smaller for mothers whose infants were colicky at 6 weeks of age, were not significantly different from those of mothers whose infants were never colicky. CONCLUSION: This study provides support for the belief that, in most cases, colic is self-limiting and does not result in lasting effects to maternal mental health.

Colic↗
PubMed1995

Infantile colic. Seasonal incidence and crying profiles.

OBJECTIVES: To determine the occurrence of infantile colic and its seasonal variation in an unselected population and to evaluate the amounts of crying in colicky infants and noncolicky controls. DESIGN: Questionnaire survey and a prospective substudy of parental diaries of crying. SETTING: All families with a full-term, healthy-born infant in the Turku City (Finland) district during 1 year. PARTICIPANTS: Colic was defined as paroxysms of crying for 3 or more hours per day for 3 days or more per week during a period of at least 3 weeks. The questionnaires containing this definition were distributed to 1221 families in postpartum wards, and an invitation to a prospective follow-up study was presented to the families if their infant showed colicky symptoms. The incidence questionnaire was to be returned after 3 months. Six hundred four (49%) of the questionnaires were returned, and an additional 355 (29%) families were reached by phone. A total of 59 families with a colicky infant enrolled in the prospective substudy when the infants were at a median age of 5 weeks; age-matched controls were invited from the same population. RESULTS: The incidence of infantile colic was 13%; possible infantile colic was 8%. No seasonal variation was found. The mean amount of total crying was 241 min/d (95% confidence interval [CI], 216 to 266 minutes) in the colic group and 112 min/d (95% CI, 95 to 130 minutes) in the control group during the first recording week. The mean amount of colicky crying was 122 min/d (95% CI, 102 to 142 minutes) in the colic group and 19 min/d (95% CI, 12 to 26 minutes) in the control group. CONCLUSIONS: The incidence of colic was 13% with no seasonal variation. Parental perception of infantile colic correlated well with the amount of crying.

Colic↗
PubMed1984

Infantile colic: occurrence and risk factors.

The purpose of this work was to study the appearance of infantile colic and gas discomfort and to learn whether these problems are associated with factors in the child's social environment, allergic symptoms, or feeding. The study was made retrospectively by means of a questionnaire which was sent to mothers of every tenth child aged 14 to 38 months in Turku, Finland. Forty percent of the children, as many boys as girls, had colic or gas problems in early infancy, so severe in 20% that drug therapy was used. First born children in the family more often had colic and gas problems than did subsequent children. Siblings of colicky children had colic and gas problems more often than did siblings of the children who had no colic or gas problems. Neither family history or symptoms of allergy, duration of breast-feeding, mother's consumption of plain cow's milk during lactation, nor the age of introduction of cow's milk to the child were associated with the occurrence of colic. Children with colic grew as well as children without. However, their night sleep was more often disturbed by awakenings than the night sleep of children without colic or gas problems in early infancy.

Age Factors↗
PubMed1995

A comparison of temperament and maternal bother in infants with and without colic.

This descriptive, retrospective study compared the temperament styles of 25 4- to 8-month-old infants who had colic with the temperament styles of 30 infants of similar age without colic. Infant temperament style was characterized by the mother's ratings of her infant's behavioral style. The degree of bother that the mother experienced in relationship to her infant's temperament also was examined. Results indicated that mothers of infants with colic rated their infants' temperaments differently than mothers of infants without colic in the temperament dimensions of activity and mood. Mothers of infants with colic were more bothered by the infants' temperament dimension of mood than were mothers of infants without colic. More infants in the colic group were characterized as difficult than were infants in the noncolic group. Individual temperament characteristics should be considered in the differential diagnosis of primary excessive crying (colic) during the newborn and infant periods.

Adult↗
PubMed2000

Infantile colic and food hypersensitivity.

In this article, some aspects of the phenomenon of infantile colic or fussing and crying behavior in early infancy are reviewed. The major points addressed are as follows: 1) evidence that infants with colic differ significantly in their pattern of distressed behavior from noncolicky infants; 2) the evidence of colic in children with known food allergy; 3) the incidence of food allergy in children with colic; 4) the outcome of trials focusing on the dietary management of colic; 5) the outcome of studies involving behavior modification in colic; 6) the outcome of a preliminary trial of modification of maternal diet in very young infants with colic; and 7) findings of a systematic review of different treatments for colic.

Behavior↗
PubMed2000

Colic surgery in 206 juvenile thoroughbreds: survival and racing results.

The purpose of our study was to determine the types of lesions that cause colic in juvenile Thoroughbreds, factors associated with these lesions and the subsequent survival and athletic performance of the juveniles. The age of juvenile Thoroughbreds requiring surgical exploration for abdominal pain has an influence on the type of lesion causing colic. The short-term survival rate (discharge from the hospital) after colic surgery for foals was 85% and was strongly influenced by the lesion causing colic. Thirteen percent of juveniles recovered from the first surgery experienced another severe colic episode requiring additional surgery or euthanasia. Eight percent of foals recovered from the first celiotomy developed adhesions. Adhesion formation was related to the initial lesion causing colic and the foals' age at the first surgery. Foals being suckled (15 days to 6 months) were at greatest risk for adhesions and more frequently required multiple surgeries. Juvenile Thoroughbreds that had a celiotomy were significantly less able to race (63%) than their unaffected siblings (82%), and age at the initial surgery was associated with the percentage of horses that raced. However, affected foals able to race won as much money, raced as often, and made as many starts as their siblings. Colic and surgical treatment have a negative impact on athletic performance, but the majority of foals discharged from the hospital after colic surgery will perform athletically as adults.

Animals↗