Multiple venous thrombosis in inflammatory bowel disease.
Explore the source record for details and available documents.
Adrenal Cortex Hormones↗
Biomedical subjects
H R Jenkins
Publications and source records attributed to H R Jenkins.
Incidence of coeliac disease.
Explore the source record for details and available documents.
Adolescent↗
Congenital chloride-losing diarrhoea: absence of the anion-exchange mechanism in the rectum.
BACKGROUND: Congenital chloride-losing diarrhoea is characterized by a defect in chloride/bicarbonate exchange, which is normally present in the ileum and colon. Whether the defect is an absence or a reversal of such an exchange is unclear, and we have investigated two young children with the disorder to answer this question. METHODS: We used a previously described nonequilibrium rectal dialysis method, using different dialysate anion concentrations, to investigate the movement of sodium, potassium, chloride, and bicarbonate in the rectum of the two children. RESULTS: The results showed that chloride and bicarbonate movements were not linked in any active way, and both ions appeared to move passively in response to the electrochemical gradients generated. CONCLUSIONS: In the two subjects studied, the defect in the rectum appears to be an absence of the normal anion exchange mechanism present in the bowel, rather than its reversal.
Bicarbonates↗
The technetium white cell scan as an initial imaging investigation for evaluating suspected childhood inflammatory bowel disease.
BACKGROUND: The technetium white cell scan (WCS) may be a useful investigation for patients with inflammatory bowel disease (IBD). In a retrospective study we assessed the use of the WCS as an initial imaging investigation in evaluating children with suspected IBD. METHODS: Over a 3-year period, 60 WCS were performed on 55 patients (25 boys, median age 12.1 years, age range 1.5-18 years) with known or suspected IBD. There were two clinical groups: those with previously diagnosed IBD (histologically and radiologically) and in clinical relapse (13 patients), and newly presenting patients with suspected IBD (42 patients). RESULTS: Eighteen scans were performed on the 13 patients presenting with relapse. Seventeen were positive and one patient, subsequently shown to have an inactive stricture, had a negative scan. Seven of the 42 newly presenting patients had abnormal scans, confirmed to be due to IBD by a combination of histology and barium examinations. Of the remaining 35 scans, three were abnormal and 32 were normal. None of these patients were subsequently proven to have IBD. These results show that in detecting active IBD, a positive WCS has a 100% sensitivity (24/24) and a 91% specificity (32/35) in the diagnosis of IBD. CONCLUSIONS: Our results show that the WCS is very useful as an initial imaging investigation in evaluating patients with suspected IBD to select patients for further investigation.
Adolescent↗
Experience of percutaneous endoscopic gastrostomy in children with Crohn's disease.
Enternal nutrition is an important mode of treatment for Crohn's disease in children. Percutaneous endoscopic gastrostomy has been little used, even through it can facilitate the administration of an unpalatable elemental diet to an anorexic, undernourished patients. Its use is reported in 10 children with Crohn's disease. The gastrostomy was found to be more acceptable than a nasogastric tube and was associated with only minor complications. As a consequence of improved delivery of enteral nutrition, in the year after the insertion of the gastrostomy there was a reduction in prednisolone dosage in all patients, with six patients being able to stop prednisolone completely. The SD score for height also improved significantly. It is suggested that percutaneous endoscopic gastrostomy is both useful and safe in the management of Crohn's disease in children, particularly when compliance with an elemental diet is likely to be poor.
Adolescent↗
Inflammatory bowel disease and predisposition to osteopenia.
The prevalence of osteopenia in children with inflammatory bowel disease (IBD) is unknown. The effect of nutritional state, disease activity, and steroid therapy on bone mineral content (BMC) of whole body, lumbar spine, and left femoral neck measured by dual energy x ray absorptiometry in 32 children with IBD was assessed by comparison with 58 healthy local school children. Using the control data, a predicted BMC was calculated taking into account bone area, age, height, weight, and pubertal stage. The measured BMC in children with IBD was expressed as a percentage of this predicted value (% BMC). Mean (SD) % BMC was significantly reduced for the whole body and left femoral neck in the children with IBD (97.0 (4.5)% and 93.1 (12.0)% respectively, p < 0.05). Of the children with IBD, 41% had a % BMC less than 1 SD below the mean for the whole body and 47% at the femoral neck. Reduction in % BMC was associated with steroid usage but not with the magnitude of steroid dose, disease activity, or biochemical markers of bone metabolism. In conclusion, osteopenia is relatively common in childhood IBD and may be partly related to the previous use of steroids.
Adolescent↗
Faecal chymotrypsin in small for gestational age infants: effects of nucleotides and breast feeding.
The effect of diet on pancreatic exocrine function, measured by faecal chymotrypsin activity (FCA), was studied longitudinally in three groups of small for gestational age (SGA) infants in the first six months of life. The three groups comprised breastfed infants (group B), those randomly allocated to receive a standard infant formula (group S), or the same formula supplemented with nucleotides (group N). The three groups did not differ in their birthweight or gestational age. Nucleotide supplementation of infant formula improves catchup growth in SGA infants but whether this is due to effects on the gastrointestinal mucosa or the exocrine pancreas is not known. There were no differences in FCA at study entry but by one month group B had significantly lower values than the other groups, and this was maintained at 2, 4, and 6 months. Groups N and S did not differ significantly at any time point. Nucleotide supplementation of infant formula does not influence pancreatic exocrine function and its effect on growth is unlikely, therefore, to be mediated through the pancreas. This study shows that breast feeding is associated with lower FCA which may be related to the lower protein content of human milk. Reliable interpretation of FCA in young infants requires information about their diet.
Bottle Feeding↗
Bone mineral density in Crohn's disease.
Explore the source record for details and available documents.
Bone Density↗
The epidemiology of paediatric inflammatory bowel disease.
A retrospective study of the incidence and prevalence of paediatric inflammatory bowel disease over an 11 year period was undertaken in South Glamorgan. Over this time the incidence of Crohn's disease more than doubled from 1.30 cases per 100,000 childhood population per year in the period 1983-1988, to 3.11 cases per 100,000 population per year in the period 1989-1993. In contrast, the incidence of ulcerative colitis remained the same throughout the study period at 0.71 per 100,000 per year. In 1993 the prevalence of Crohn's disease in the childhood population was 16.6 per 100,000 and of ulcerative colitis, 3.42 per 100,000.
Adolescent↗
Nucleotide supplementation and the growth of term small for gestational age infants.
A double blind randomised controlled trial in small for gestational age (SGA) infants, whose intestinal mucosa was shown to be functionally impaired as a result of intrauterine undernutrition, was carried out to investigate the hypothesis that nucleotide supplementation of a milk formula could improve catchup growth. Anthropometric data were collected on 74 infants, 39 randomly allocated to the nucleotide supplemented group (group N) and 35 to a standard formula group (group S). From study entry to 2 months of age, infants in group N had significantly higher mean rates of weight gain (106.3 compared with 94.7 g/kg baseline weight/week) and length gain (21.8 v 19.7 mm/m baseline length/week). Over the whole six months for which the trial formula was provided group N had significantly higher mean rates of gain of weight (80.1 compared with 71.8 g/kg baseline weight/week), length (16.2 compared with 15.0 mm/m baseline length/week), and head circumference (11.8 compared with 10.8 mm/m baseline head circumference/week). Catchup growth in SGA infants is therefore improved by nucleotide supplementation of infant formula.
Anthropometry↗
Absorption of a new oral formulation of cyclosporin A in a child on parenteral nutrition.
A 2-year-old child underwent renal transplantation in the presence of a post-viral enteropathy rendering him dependent on total parenteral nutrition. As part of his immunosuppression, he was given a new oral formulation of cyclosporin A (Neoral), which he was able to absorb satisfactorily, using conventional doses, during the 6 weeks he was dependent on intravenous nutrition and in the face of intermittent severe diarrhoea. An unusual pharmacokinetic profile was observed.
Administration, Oral↗
Osteopenia in Crohn's disease.
A 16 year old boy presented soon after diagnosis of Crohn's disease with diffuse osteopenia of the lumbar spine with collapse of three vertebral bodies and grossly reduced bone mineral density noted on dual energy x ray absorptiometry scan. Treatment of the underlying Crohn's disease and induction of puberty resulted in marked improvement in bone mineralisation.
Absorptiometry, Photon↗
Radiological assessment of constipation.
A scoring system for faecal loading was constructed by two experienced observers using the abdominal radiographs of 20 children. Four other observers independently graded the radiographs using this system and there was a high degree of agreement between all six observers (p < 0.001), suggesting that radiological assessment of constipation can be standardised.
Adolescent↗
Radiological evidence of constipation in urinary tract infection.
Little objective evidence has been published to support the claim that constipation is an important contributory factor in recurrent urinary tract infection (UTI) in childhood. Using a radiological scoring system, two observers assessed faecal loading from abdominal radiographs of children with proved UTIs. There was a significant increase in the degree of faecal loading in children with UTI when compared with controls (r = 0.237). This difference was mainly accounted for by girls with recurrent (greater than five) UTIs. This study confirms an association between recurrent UTI and faecal loading. Further studies are needed to establish if there is a causal relationship and benefits from treatment.
Adolescent↗
Constipation and reversible urinary tract abnormalities.
Urinary tract anomalies were prospectively investigated with ultrasound in 29 children with functional constipation. These children were compared before and after treatment with 451 age matched healthy controls without constipation. The bladder residue and upper renal tract dilatation after micturition were significantly increased in the group with constipation and improved after treatment.
Adolescent↗
Systemic vasculitis complicating infantile autoimmune enteropathy.
An infant with unexplained sideroblastic anaemia and severe protracted diarrhoea due to autoimmune gut disease is reported. Despite treatment with an exclusion diet and immunosuppressive agents she developed a severe systemic vasculitic illness. Intensive treatment with plasmapheresis resulted in resolution of the vasculitic process but the child subsequently died after overwhelming septicaemia.
Anemia, Sideroblastic↗
The effect of colitis on large-intestinal electrolyte transport in early childhood.
The large intestine plays an important role in the salvage of electrolytes and water, although little is known of its function in early childhood in health or in disease. Using an in vitro voltage clamp technique, we have measured bidirectional sodium (Na) and chloride (Cl) fluxes (J), electrical potential difference (PD), short circuit current (Isc), and tissue resistance (R) in 10 pairs of healthy human infant left colon and four pairs of inflamed colon. In healthy tissue there was net Na and Cl absorption with JNa net approximating Isc. In contrast, inflamed colon exhibited significant reductions in PD, Isc, and R and increases in net serosa to mucosa flux of Na and Cl (JNasm and JClsm) resulting in net Na and Cl secretion. These results suggest that Na and Cl absorption in left colon is highly efficient in young children and that mucosal inflammation may seriously impair the colon's ability to conserve salt and water.
Anus, Imperforate↗
In vitro studies of sodium transport in human infant colon: the influence of acetate.
In infants, adequate colonic function is vital in preventing electrolyte and water depletion. In certain species, short-chain fatty acids have been shown to increase colonic Na absorption. Using an in vitro voltage-clamp technique, we have studied the characteristics of electrolyte transport in isolated preparations of human left-sided colonic mucosa and investigated the effect of acetate on epithelial Na movement. In the basal state, there was net Na absorption that was entirely electrogenic. The addition of mucosal acetate resulted in a significant increase in net Na absorption that was markedly inhibited by amiloride, suggesting that, in the young child, the presence of short-chain fatty acids promotes colonic salvage of Na and that such salvage of Na may be via an amiloride-sensitive Na channel and involve stimulation of sodium-hydrogen exchange.
Acetates↗