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Biomedical subjects

Mark R Oliver

Publications and source records attributed to Mark R Oliver.

9 recordsLinked to original sources
PubMed2006

Is significant cystic fibrosis-related liver disease a risk factor in the development of bone mineralization abnormalities?

In order to assess the effects of significant cystic fibrosis-related liver disease (CFLD) on bone health, we compared the bone mineral status of older children and adolescents with CFLD to those with cystic fibrosis (CF) alone. Thirteen children (age range, 10-19 years) from our clinical CF services were identified with significant CFLD (9 of these 13 patients had clinical and radiological evidence of portal hypertension). This cohort was then matched by age, gender, and anthropometric measurements with equal numbers of patients with CF alone. All patients had a dual-energy X-ray absorptiometry (DEXA) scan to determine bone mineral content (BMC), bone area (BA), bone mineral density (BMD), and bone mineral apparent density (BMAD) in the region of the lumbar spine. Blood was drawn to determine serum vitamin A, D, E, and K status and liver function tests. The best forced expired volume in 1 sec (FEV1) for each patient in the 12 months around the time of the scan was also documented. Patients with CFLD had slightly worse FEV1 (82 +/- 20% vs. 91 +/- 16%, P = 0.05) and significantly higher alanine aminotransferase (65.5 +/- 35 IU/l vs. 30 +/- 20 IU/l, P = 0.01) than those with CF alone. The mean lumbar spine BA, BMC, BMD, and BMAD were not different between children with CFLD and CF. In conclusion, the presence of significant liver disease in children with CF does not appear to be an additional risk factor for the development of abnormal bone mineralization.

Absorptiometry, Photon↗
PubMed2006

Childhood pancreatitis.

Inflammation of the pancreas has many presentations in children and adolescents. The etiology is often elusive, with a great number of cases being idiopathic. However, there have been a number of recent advances in the areas of cell biology, genetics and imaging technology, which should be highlighted. Herein is provided a review for the reader with particular emphasis on some of these newer advances.

Acute Disease↗
PubMed2005

Intussusceptions arising from two different sites in a child with cystic fibrosis.

Abdominal pain is common in individuals with cystic fibrosis (CF). We report on a 17-year old boy with CF and two recognized intussusceptions: the first colonic intussusception was presumed due to distal intestinal obstruction syndrome, and the second enteric one due to polypoid lesions containing heterotopic gastric mucosa. The presentation, pathology, management, and a literature review of intussusception in CF are discussed.

Adolescent↗
PubMed2005

Colonic manometry via appendicostomy shows reduced frequency, amplitude, and length of propagating sequences in children with slow-transit constipation.

BACKGROUND/PURPOSE: We wish to define colonic motor function in children with slow-transit constipation (STC) using manometry catheters introduced through appendiceal stomas, previously sited for controlling fecal retention by colonic irrigation. METHODS: We undertook 24-hour pancolonic manometry of 6 children (5 boys; mean, 11.5 years; SD, 3.0) using a multilumen silastic catheter. RESULTS: were compared to nasocolonic motility studies obtained in healthy young adults. RESULTS: Antegrade propagating sequences (APSs) originated less frequently in the cecum compared to controls. There were fewer APS (mean +/- SEM: STC, 13 +/- 6 per 24 hours; controls, 52 +/- 6 per 24 hours; P < .01) and high-amplitude propagating contractions (HAPCs: STC, 5 +/- 2 per 24 hours; controls, 9.9 +/- 1.4 per 24 hours; P < .05). The amplitude of APS and HAPC was less in STC (APS, 39 +/- 9 mm Hg; controls, 54 +/- 3 per 24 hours; P < .05) (HAPC: STC, 94 +/- 10 mm Hg; control, 117 +/- 3 mm Hg; P < .01), whereas the amplitude of retrograde propagating sequences was greater in STC (43 +/- 6 mm Hg; control, 27 +/- 1 mm Hg; P < .01). The distances propagated by HAPC were significantly less in STC (36 +/- 4.5 vs 47 +/- 2.3 cm, controls; P < .05), and there was no evidence of a region-specific difference in propagation velocity of APS. Neither meal ingestion nor waking significantly increased colonic motor activity in patients with STC. CONCLUSIONS: Despite the small numbers available to be studied, we found that children with STC in whom an appendicostomy had been placed show significant abnormalities in pancolonic motor function.

Adolescent↗
PubMed2005

Surgical management of a pancreaticopleural fistula in a child with chronic pancreatitis.

Chronic pancreatitis in children rarely results in the development of a recalcitrant pleural effusion, secondary to a connection between the pleural cavity and the pancreas. We describe such a case and the curative surgical therapy and include a brief discussion of the relevant medical literature as it pertains to this complication in the pediatric population.

Child↗
PubMed2004

Factors affecting clinical outcome in gastrostomy-fed children with cystic fibrosis.

In order to assess the effects of gastrostomy feeding on nutritional status, respiratory function, and survival in children with cystic fibrosis (CF), we studied all patients undergoing gastrostomy between 1989-1997 at the Royal Children's Hospital, Melbourne. Clinical information was collected from medical records, including serial measurements of weight-for-age standard deviation scores (WAZ) and forced expired volume in 1 sec (FEV1) (percent predicted). Measurements were compared for 2 years before and 2 years after gastrostomy placement. Data on gastroesophageal reflux (GER), adherence to the gastrostomy feeding program, and sputum culture were also assessed. Of 37 children (22 male; mean age, 11.6 +/- 4.8 years; range, 3-20), 11 died during the study period (7 female, 4 male). Female patients were more likely to die within 2 years of gastrostomy placement (OR = 3.9; 95% CI, 0.72-23.2; P = 0.07). Mortality was significantly associated with a WAZ score < -2 (OR = 10.7; 95% CI, 1.07-466.6; P = 0.02) and predicted FEV1 < 50% (OR = 10.8; 95% CI, 1.07-512.9; P = 0.02) at time of gastrostomy. Patients with clinical evidence of GER (n = 11) had significantly lower weight gain after gastrostomy (delta WAZ, -0.32 +/- 0.26 vs. 0.03 +/- 0.39; P = 0.03). In conclusion, the presence of advanced lung disease, GER, and female gender were factors associated with a poor clinical outcome after gastrostomy placement.

Adolescent↗
PubMed2003

Esophageal eosinophilia in children with dysphagia.

OBJECTIVES: Children occasionally have dysphagia in the absence of an apparent primary cause. Esophageal eosinophilia is sometimes seen in these patients at the time of upper endoscopy but its significance is not clear. Although eosinophilia is regarded by some as a histologic hallmark of childhood reflux esophagitis, it may in fact signal a primary eosinophilic esophagitis in children with dysphagia. Our aim was to evaluate esophagitis, acid reflux determined by pH probe, and esophageal eosinophilia in children with the primary complaint of dysphagia. METHODS: A retrospective study was performed in 42 children, admitted for investigation of dysphagia, in whom no primary cause could be found. Twenty-one children (mean age +/- SD, 10.1 +/- 4.0 years) had esophageal eosinophilia and 21 children (8.3 +/- 4.7 years) did not. Clinical, endoscopic, manometric and esophageal pH parameters in these two groups were compared. RESULTS: Patients with esophageal eosinophilia were more often male (p<0.01) with a history of allergy (p<0.001) and food bolus obstruction (p<0.05) requiring endoscopic removal. Their esophageal mucosa appeared wrinkled and thickened at endoscopy with basal cell proliferation, and large numbers of eosinophils in esophageal mucosal biopsies. Continuous esophageal pH records and motility studies, when obtained, were similar in both groups and were within normal values. CONCLUSION: Children with dysphagia who have esophageal eosinophilia are unlikely to have pathologic gastroesophageal reflux.

Adolescent↗