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Biomedical subjects

G Fluge

Publications and source records attributed to G Fluge.

At least 19 recordsLinked to original sources
PubMed2003

Intragastric maldistribution of a liquid meal in children with recurrent abdominal pain assessed by three-dimensional ultrasonography.

BACKGROUND: Using two-dimensional (2D) ultrasonography, we previously found indications of impaired adaptive relaxation of the proximal stomach in children with recurrent abdominal pain (RAP). In the present study, we applied a new three-dimensional (3D) ultrasonographic method to investigate intragastric volumes and distribution of a liquid meal in another group of children with RAP. METHODS: Twenty patients with RAP (age 10-15 years) and 20 healthy subjects (age 11-15 years) underwent ultrasonographic measurements of the stomach. A position sensor was used based on magnetic scanhead tracking for acquisition of 3D images after a liquid meal. The children scored abdominal symptoms before and after the meal. RESULTS: Expressed as a fraction of ingested volume, the patients had a smaller volume of the proximal stomach and a larger antral volume at 2 min postprandially compared to healthy subjects (P = 0.03 and P = 0.001, respectively). The patients also showed a decreased proximal to distal gastric volume ratio at 2 min postprandially (P = 0.001). Patients experienced more pain in response to the meal than healthy subjects (P = 0.04), but there was no correlation between pain and proximal or distal gastric volumes. CONCLUSIONS: RAP in children may be associated with an early intragastric maldistribution of a meal.

Abdominal Pain↗
PubMed2002

Faecal calprotectin levels in infants with infantile colic, healthy infants, children with inflammatory bowel disease, children with recurrent abdominal pain and healthy children.

UNLABELLED: This study investigated faecal calprotectin concentration, a measure of intestinal inflammation, in infants and children with abdominal pain. Faecal calprotectin was measured by an enzyme-linked immunosorbent assay kit in spot stool samples in 76 infants with typical infantile colic, 7 infants with transient lactose intolerance and 27 healthy infants. All infants were 2-10 wk of age. In addition, 19 children with recurrent abdominal pain (RAP; mean age 11.5 y), 17 with inflammatory bowel disease (IBD; mean age 11.1 y; 10 had Crohn's disease and 7 ulcerative colitis) and 24 healthy children (mean age 5.3 y) were studied. In infants with infantile colic the mean faecal calprotectin concentration was not different from that in healthy infants (278 +/- 105 vs 277 +/- 109 mg kg(-1), p = 0.97) or in infants with transient lactose intolerance (300.3 +/- 124 mg kg(-1), p = 0.60). The calprotectin level was similar in boys and girls and fell significantly with age (p = 0.04). Children with IBD had faecal calprotectin levels (293 +/- 218 mg kg(-1)) much higher than healthy children (40 +/- 28 mg kg(-1), p < 0.0001) and children with RAP without identified organic disease (18 +/- 24 mg kg(-1), p < 0.0001). CONCLUSION: Faecal calprotectin may differentiate between functional abdominal pain and IBD in school-aged children. In young infants high faecal calprotectin levels are normal.

Abdominal Pain↗
PubMed2001

[Gastrointestinal dysmotility in children].

Motility disorders were previously impossible to penetrate, but new technics have made it possible to investigate these disorders. An overview of neurophysiological functions of the gastrointestinal tract is given, and various conditions representing primary and secondary motility disorders are discussed. Diagnostic procedures and treatment options are presented. The clinical picture of such disorders is demonstrated by two cases. A girl born in 1995, having megacystis microcolon hypoperistalsis syndrome was the first Norwegian individual to have an intestinal transplantation, which was performed in London, UK. A girl with hypoganglionosis is also reported. Since May 1998, manometry of the oesophagus was performed in 44 children, and pathological findings were demonstrated in 18 of these patients. The motoric activity of the stomach was investigated in 17 patients using two-dimensional ultrasound and electrogastrography pre- and post-prandially. Disturbed function was found in nine of these children. Anorectal manometry was performed in 147 individuals, and Hirschsprung's disease was diagnosed in four.

Child↗
PubMed2001

Typing of Pseudomonas aeruginosa strains in Norwegian cystic fibrosis patients.

OBJECTIVES: Typing of Pseudomonas aeruginosa isolates from Norwegian cystic fibrosis (CF) patients with chronic Pseudomonas lung infection in order to see whether cross-infection might have occurred. METHODS: Isolates from 60 patients were collected during the years 1994-98, and typed by pulsed field gel electrophoresis. RESULTS: Seventy-one strains were identified. One large cluster of identical strains included 27 patients, and 13 smaller clusters of 2-4 patients were found (26 patients). Seven patients had a strain not shared by other patients (private strains). Harboring the main cluster strain was significantly associated with participation in summer camps and training courses (P = 0.004, chi-squared test). There were no associations with regular admissions to hospital (intravenous antibiotic courses) or smaller social gatherings of short duration. Small clusters and private strains were not associated with any of the risk factors. All strains were sensitive to colistin. The minimal inhibitory concentrations were generally lower in Norwegian P. aeruginosa strains compared with isolates from Danish patients. CONCLUSIONS: Our results indicate that cross-infection with P. aeruginosa between cystic fibrosis patients has occurred.

Adolescent↗
PubMed2001

Randomised controlled trial of infantile colic treated with chiropractic spinal manipulation.

AIMS: To investigate the efficacy of chiropractic spinal manipulation in the management of infantile colic. METHODS: One hundred infants with typical colicky pain were recruited to a randomised, blinded, placebo controlled clinical trial. RESULTS: Nine infants were excluded because inclusion criteria were not met, and five dropped out, leaving 86 who completed the study. There was no significant effect of chiropractic spinal manipulation. Thirty two of 46 infants in the treatment group (69.9%), and 24 of 40 in the control group (60.0%), showed some degree of improvement. CONCLUSION: Chiropractic spinal manipulation is no more effective than placebo in the treatment of infantile colic. This study emphasises the need for placebo controlled and blinded studies when investigating alternative methods to treat unpredictable conditions such as infantile colic.

Colic↗
PubMed2001

Personality profiles and heart rate variability (vagal tone) in children with recurrent abdominal pain.

UNLABELLED: The aim of the study was to explore psychological factors and autonomic activity in children with recurrent abdominal pain and to compare them with those in a control group of healthy children. The Personality Inventory for Children was used for assessment of developmental, emotional and psychosocial factors in 25 children with recurrent abdominal pain (age, 7-15 y). Parasympathetic and sympathetic functions in these children and in 23 healthy control subjects (age, 7-13 y) were also investigated, non-invasively using a computerized polygraph. Vagal tone (parasympathetic function) was indexed by calculation of respiratory sinus arrhythmia in beats/min. Skin conductance (sympathetic function) was recorded by the constant current method. On the Personality Inventory for Children, 16 patients had high scores on somatic concern. Several patients had scores in the clinical range for depression, withdrawal and anxiety, but the mean scores for these personality profile scales were well within the normal range of healthy children. Interestingly, there was a spike on the L (Lie)-scale for most of the patients and 15 patients had scores above or close to the clinical cut-off value. As compared with the scores in healthy children, vagal tone and sympathetic tone were normal. CONCLUSION: Many children with recurrent abdominal pain have scores in the clinical range for depression, withdrawal, anxiety and L-scale indicating coping problems, denial and a trend towards somatic concern that may contribute to the evolution of abdominal pain. Autonomic nerve activity was not disturbed in these children.

Abdominal Pain↗
PubMed2000

[Cystic fibrosis in the Western health region].

78 patients with cystic fibrosis have been diagnosed in western Norway (Health Region 3) since 1960. 31 were born before 1971 (40%). 44 patients were born in the county of Hordaland (62%), including the city of Bergen where the western Cystic Fibrosis Centre is located. 24 (31%) patients were born in Rogaland, and five (7%) in Sogn & Fjordane. 12 patients have died, 9 of them born before 1971 (survival in this cohort of patients is 71%). During two decades from 1971 to 1990, 3 out of 33 patients have died (survival 91%). All patients born after 1990 are alive. The median age at death was 18.5 years. Among patients alive in 1999, 32 (41.5%) are more than 20 years and 19 (24.7%) are more than 30 years old. Median age among all patients is 19.5 years (range 3-51). Chronic lung infection with Pseudomonas aeruginosa has been diagnosed in 20.8% of all patients, which is lower than the average of Norwegian cystic fibrosis patients (35%). Survival among cystic fibrosis patients in Western Norway is good compared to data from other countries. It seems realistic to expect that our patients should achieve a median survival to more than 30 years of age.

Adolescent↗
PubMed2000

[Esophageal stricture as a complication of gastroesophageal reflux in children].

General practitioners and paediatricians often get in contact with children who present with regurgitation and vomiting. To some extent, regurgitation is a normal situation in infants during their first months of life. Abnormal gastrooesophageal reflux, however, should be diagnosed and treated adequately, as there is a risk of complications. At the Department of Paediatrics, Haukeland Hospital, Bergen we have diagnosed oesophageal strictures due to undiagnosed gastrooesophageal reflux in six children. One patient had previously been treated for gastrooesophageal reflux during infancy. The main reasons for admitting the children were dysphagia and weight loss. When the correct diagnosis had been established, the patients were treated with cisapride and omeprazole orally. Several dilatations of the strictures were performed by upper endoscopy. A Nissen's fundoplication has been performed in two patients and is probably necessary to undertake in the remaining four. Clinical awareness of gastrooesophageal reflux is important, since undiagnosed reflux carries a risk of oesophagitis and stricture formation.

Child↗
PubMed2000

Impaired accommodation of the proximal stomach in children with recurrent abdominal pain.

BACKGROUND: A new ultrasonographic method was applied in children with recurrent abdominal pain, to study accommodation of the proximal stomach to a meal. METHODS: After an overnight fast, 20 patients with recurrent abdominal pain (age, 7-14 years) and 23 healthy control subjects (age, 7-13 years), were scanned by a 5-MHz transducer positioned in the epigastrium, to monitor the size of the proximal stomach before and after a test meal of meat soup. RESULTS: Children with recurrent abdominal pain had a significantly smaller sagittal area of the proximal stomach at 10 and 20 minutes after the meal than in healthy control subjects (P = 0.01 for both) and significantly higher emptying fraction of the proximal stomach at 10 minutes after the meal than in healthy control subjects (P = 0.02). There was no significant difference in emptying of the distal stomach between the patients and healthy control subjects. Children with recurrent abdominal pain experienced more symptoms (pain, bloating) in response to the test meal than did healthy control subjects. CONCLUSION: The results support the view that recurrent abdominal pain in children may be a motility disorder that can be detected in the proximal stomach as an impairment of adaptive relaxation in response to a meal. This new ultrasonographic method may become a valuable diagnostic tool in patients with recurrent abdominal pain.

Abdominal Pain↗
PubMed1999

[Dietary treatment of celiac disease].

Life-long gluten-free diet is the established therapy of coeliac disease. Patients suffering from dermatitis herpetiformis benefit from the same treatment. In Norway the gluten-free diet has excluded oats as well as wheat, rye and barley. The basis for this recommendation was a 1972 report indicating that ten out of 23 children consuming oats as part of their gluten-free diet for at least 18 months developed signs of damage to the intestinal mucosa. During the last decades, the clinical picture of coeliac disease has changed as a result of better diagnostic tools. Controlled clinical trials during the last few years indicate that some patients may tolerate small amounts of oats in their gluten-free diet. As a consequence, patients may be confused with regard to what dietary regime is recommended in coeliac disease. Compliance with gluten-free diet is important to secure growth and development, the all-round condition, fertility, bone density and a reduced risk of nutrient deficiency and malignancy. Consensus on dietary treatment is essential. A number of controlled trials are under way and the outcome of these studies will in a few years determine whether oats might be included in the standard gluten-free diet. So far oats are not recommended. The physician who makes the diagnosis is responsible for all patients getting adequate dietary counselling and management. Dietary advice given by health personnel must be consistent.

Adult↗
PubMed1999

High prevalence of asymptomatic coeliac disease in Norway: a study of blood donors.

OBJECTIVE: The prevalence of symptomatic coeliac disease in Norway is 1:675. Coeliac disease has previously been reported in presumably healthy people. Our aim was to determine the prevalence of latent coeliac disease in apparently healthy (i.e. asymptomatic) Norwegian individuals. METHODS: Blood donor sera were tested for gluten antibodies (IgA, IgG). Positive samples (IgA AGA > 0.35, IgG AGA > 0.90) were further tested for endomysium antibodies (IgA EMA). EMA positive individuals were offered gastroenterological investigation. RESULTS: Of 2096 sera, 83 fulfilled the criteria for EMA testing (M/F = 55/28). Eight individuals were EMA positive. On biopsy, seven out of eight had villous atrophy (six subtotal, one partial). None of the patients had significant symptoms. Biochemical data showed iron deficiency (two), hypocalcaemia (one), and low serum zinc (five). All patients were treated with a gluten-free diet and followed up. CONCLUSION: The study indicates a prevalence of 1:340 among asymptomatic and presumably healthy people. This is in keeping with studies from other countries. Lack of symptoms does not exclude secondary deficiency conditions.

Adolescent↗
PubMed1998

[The importance of nutrition for cancer patients].

Good nutrition and nutritional therapy are important for cancer patients before, during and after treatment. The goal for the dietary advices and the nutritional therapy is to maintain or improve the nutritional status of the cancer patients. This seems to have beneficial effects on the oncological therapy. To achieve good results by using nutritional therapy in cancer treatment, a close collaboration between nutritionists, doctors and nurses will be important. The National Nutrition Council initiated in 1996 a working group in order to provide recommendations for diet and nutritional therapy in cancer patients. The group performed a literature review and studied the practice of nutritional therapy in Norwegian hospitals using a mailed questionnaire answered by 33 (72%) hospital departments. This paper gives a summary of this work.

Dietary Services↗
PubMed1997

[Guidelines for diagnosis and follow-up of patients with celiac disease. Norwegian Coeliac Association].

The incidence and prevalence of coeliac disease in Norway is probably much higher than previously recognized. A prevalence of 1 per 676 individuals has been reported among adults in Norway. A much higher incidence has been documented in Sweden, both among children (one per approximately 300 liveborns) and among adults (1:256 healthy blood donors). Similar prevalence figures have been reported from Italy among young students. Eight new, biopsy-proven cases of coeliac disease were recently found by screening 2296 blood donors in Bergen (1:287). The symptoms of coeliac disease are often vague. Oligo- and asymptomatic cases often occur. The advisory council of the Norwegian Coeliac Association has established guidelines for the diagnostic work-up and for follow-up of patients with coeliac disease, in order to raise awareness of the disease, achieve a standardized work-up procedure and improve follow-up.

Adult↗
PubMed1994

[Indirect genetic diagnosis of cystic fibrosis].

The diagnosis cystic fibrosis was made in a three years old girl. Her older brother and her mother's sister both had minor symptoms and signs suggestive of this disease. None of 17 mutations in the gene locus for cystic fibrosis was identified in the patient by DNA-analyses. By haplotype analyses her brother, but not her aunt, was shown to share the proband's haplotypes. This family is used as an example of the general diagnostic potential of indirect diagnosis of genetic disease by haplotype analysis. The prerequisite for haplotype analysis is the availability of DNA from both the patient and the patient's relatives, stressing the need for a DNA bank of material from persons with inherited disorders, for future use.

Child, Preschool↗
PubMed1994

In vitro toxicity of purified gluten peptides tested by organ culture.

Various subfractions of Frazer fraction III were separated by high-pressure liquid chromatography, and their toxicity in vitro (organ culture) was tested in comparison with alpha-gliadin using duodenal biopsies from 25 patients with active celiac disease and subtotal villous atrophy, 2 patients with partial villous atrophy, and 10 nonceliac controls. One dominating fraction, designated Frazer III-2-VIII, was purified by several steps of rechromatography. It was markedly toxic to duodenal explants from patients with active celiac disease. The mean enterocyte height after culture was 15.9 microns compared with 25.6 microns in gluten-free medium. This difference was statistically significant in all cases except one, in which the lowest concentration (110 micrograms) was used. The in vitro toxicity of Frazer III-2-VIII was comparable with the toxicity of alpha-gliadin in twofold to fivefold higher concentrations. No toxicity could be detected in nonceliac explants (mean enterocyte height, 25.7 vs. 24.9 microns in gluten-free medium). The N-terminal amino acid sequence was (Gln)-Ile-Gln-Val-Phe-Pro-Ser-Gly-Gln-Val-Gln-(Trp)-Pro-Gln-Gln-(Gln)-Gl n-Pro- Phe-Pro. This sequence was not homologous to previously reported sequences of toxic gluten peptides. By use of the SwissProt and GenEMBL databases, it was concluded that the peptide Frazer III-2-VIII is part of the gamma-gliadin fraction.

Adolescent↗