PubMed Health⌕ Search

Biomedical subjects

R J Merritt

Publications and source records attributed to R J Merritt.

At least 37 records · Page 2Linked to original sources
PubMed1983

Effect of total parenteral nutrition on marrow recovery during induction therapy for acute nonlymphocytic leukemia in childhood.

Ten well-nourished children with acute nonlymphocytic leukemia (ANLL) were randomly assigned to groups that received (a) total parenteral nutrition (TPN) throughout the period of induction therapy or (b) standard nutritional support. Body mass and skin hypersensitivity reactions were better maintained in experimental patients. Patients on TPN had higher total white blood counts, absolute granulocyte counts, and platelet counts than did control patients during the course. No difference was apparent in the frequency of febrile episodes, or other aspects of the patients' courses. This preliminary report suggests that intensive nutritional support may accelerate the recovery of normal marrow function during induction therapy for ANLL.

Acute Disease↗
PubMed1983

Fecal alpha 1-antitrypsin excretion in young people with Crohn's disease.

Fecal alpha 1-antitrypsin excretion, a noninvasive indicator of protein-losing enteropathy, was correlated with clinical disease activity in pediatric patients with Crohn's disease. Disease activity was defined as the sum of 11 abnormal clinical parameters which were adapted from previously published disease activity scoring methods. Each patient was also given a subjective clinical rating when evaluated. In addition, four different devised disease activity scoring methods were correlated retrospectively with subjective clinical ratings for hospitalized patients. A total of 125 random fecal alpha 1-antitrypsin determinations were performed on 22 patients. Ninety-six percent of clinically active episodes of Crohn's disease were associated with elevated fetal alpha 1-antitrypsin (p less than 0.001). The degree of elevation was found not to correlate directly with the severity of assessed disease activity or site of intestinal involvement. A direct linear relationship was demonstrated between 23 paired random fecal alpha 1-antitrypsin and intestinal alpha 1-antitrypsin clearance assays (r = 0.93). There was a high, and remarkably similar, degree of correlation with each of the four different derived activity scoring methods and simple subjective ratings (r = 0.89-0.93). We conclude that: (a) fecal alpha 1-antitrypsin excretion may be helpful in assessing the presence or absence of Crohn's disease activity by providing an objective and specific indicator of intestinal damage; and (b) it appears that a simple subjective rating score is as clinically useful as other previously devised activity indices.

Adolescent↗
PubMed1982

Spectrum of amebiasis in children.

In 11 patients with childhood amebiasis, only two had dysentery. Additional clinical findings included hematochezia without diarrhea (four patients), dysentery with appendicitis (one patient), exacerbation of ulcerative colitis (two patients), and disseminated infantile amebiasis (two patients). All patients with hematochezia examined by proctosigmoidoscopy had colitis. The diagnosis of amebiasis was confirmed by microscopic examination of fresh stool specimens, pathologic findings, and/or serologic titers. Amebiasis should be considered in the differential diagnosis of infants and children with hematochezia or hepatomegaly, especially in endemic areas.

Adolescent↗
PubMed1982

Obesity.

Explore the source record for details and available documents.

Adipose Tissue↗
PubMed1982

Perinatal transmitted acute icteric hepatitis B in infants born to hepatitis B surface antigen-positive and anti-hepatitis Be-positive carrier mothers.

Three infants born to mothers who were hepatitis B surface antigen (HBsAg) positive and had antibody to hepatitis Be antigen (anti-HBe), developed acute icteric hepatitis B within three months of birth. All three infants clinically recovered and developed circulating anti-HBs. Contrary to previous studies, these three cases indicate that mother-infant transmission of the hepatitis B virus (HBV) does occur in infants born to HBsAg-positive, HBe-Ag-negative carrier mothers, and these infants may develop severe acute icteric hepatitis. Therefore, immunoprophylaxis in such newborns may be indicated.

Adult↗
PubMed1981

Iatrogenic kwashiorkor in infants.

Four children experienced kwashiorkor six weeks to six months following the introduction of a low-protein, high-fat, nondairy creamer into their diets. In all cases, the milk substitute eventually became their sole nutritional source and resulted in hypoproteinemia, edema, and hepatic abnormalities. All patients had been given the milk substitute in an attempt to control suspected milk protein sensitivity. Only one of the four patients was subsequently shown to have cow's milk sensitivity. All had complete resolution of symptoms within six weeks following institution of a nutritionally adequate diet.

Edema↗
PubMed1981

Malnutrition associated with a formula of barley water, corn syrup, and whole milk.

Five infants, age 1 to 7 months, were given a formula of barley water, whole milk, and corn syrup (Karo) or honey. Three patients had subnormal growth, two fit the criteria for failure to thrive, and two demonstrated a microcytic hypochromic anemia. The delayed growth and anemia were corrected by institution of a standard infant formula and nutrient supplementation. The barley water formula provides less than the recommended daily allowance of iron and vitamins A and C. The illnesses of these infants and the deficiencies of the diet illustrate the importance of obtaining a careful dietary history for all infants not receiving standard diets.

Animals↗
PubMed1981

Consequences of modified fasting in obese pediatric and adolescent patients: effect of a carbohydrate-free diet on serum proteins.

Serum proteins were monitored during three studies of obese adolescents treated with protein-supplemented fasting in a clinical research center. In the first study of nine patients, small but significant decreases were noted for total serum protein, albumin, transferrin, retinol-binding protein, and complement beta 1c after 4 wk of carbohydrate-free protein-supplemented fast. In a further study of four of these same patients, the substitution of 400 glucose cal for 400 fat cal in a 5th wk of dietary study returned the total protein and retinol-binding protein concentrations to base-line levels. In a 3rd study of four patients, only complement beta 1c was significantly below base-line concentrations after 3 wk on a carbohydrate-containing protein-supplemented fast. There is an apparent metabolic effect of carbohydrate ingestion on maintaining usual concentrations of serum proteins.

Adolescent↗
PubMed1981

Random fecal alpha-1-antitrypsin concentration in children with gastrointestinal disease.

Random fecal alpha-1-antitrypsin concentration was measured in children with various gastrointestinal diseases and in normal subjects. One hundred fifteen subjects were evaluated: controls (39); chronic inflammatory bowel disease (20); chronic diarrhea (18); acute gastroenteritis (17); allergic gastroenteropathy (5); chronic pancreatic exocrine insufficiency (4); acute gastrointestinal bleeding (4); nonspecific colitis (4); celiac disease (3); and intestinal lymphangiectasia (1). Mean fecal-alpha-1-antitrypsin for the controls was 0.98 mg/g lyophilized stool. All children with celiac disease, allergic gastroenteropathy, lymphangiectasia, nonspecific colitis, acute gastrointestinal bleeding, and 19 of 20 patients with active chronic inflammatory bowel disease had fecal alpha-1-antitrypsin concentrations greater than 2.6 mg/g stool (mean of the controls + 2 SD). These disorders have all been previously documented to cause protein-losing enteropathy by 51Cr-labeled albumin excretion tests. The other study patients had normal fecal alpha-1-antitrypsin excretion when compared with controls. Serial fecal antitrypsin concentrations paralleled disease activity and clinical response to therapy. The results suggest that random fecal antitrypsin concentration is a valuable screening test for mucosal disorders associated with abnormal transmucosal serum protein loss.

Adolescent↗
PubMed1980

Consequences of modified fasting in obese pediatric and adolescent patients. I. Protein-sparing modified fast.

Sixteen obese patients 9 to 16 years of age were treated with a protein-sparing modified fast for four weeks in a metabolic unit, using lean meat as the sole calorie-containing nutrient. Total weight loss was 7.11 +/- 0.33 kg (mean +/- SEM). One-half of the patients achieved positive daily nitrogen balance by the fourth week. Cumulative N balance was -28.8 +/- 10.0 gm. Serum albumin concentration remained normal. Hemoglobin and hematocrit values were stable, but decreases in total lymphocyte (P less than 0.005) and neutrophil counts (P less than 0.01) were noted. Cell-mediated immunity (four patients) remained normal. Protein synthetic and catabolic rates (two patients) revealed only minimal changes. Cumulative N balance correlated (P less than 0.01) with mean fasting serum insulin concentration, which was related (P less than 0.005) to body fat mass. The PSMF has therapeutic potential for achieving safe, rapid weight loss in severely obese older children and adolescents.

Adolescent↗
PubMed1979

Nutritional survey of hospitalized pediatric patients.

A nutrition survey in a pediatric referral center revealed one-third of patients had evidence of acute malnutrition. Weight for height was below 90% of standard in 46 of 129 (36%), arm muscle area was below the 15th percentile in 67 of 180 (37%), triceps skinfold was below the 15th percentile in 34 of 181 (19%), and total lymphocyte count was below 1500 in 26 of 137 (19%) subjects. Protein-energy malnutrition may be an important contributor to prolonged hospitalization and hospital-acquired morbidity amond United States pediatric patients.

Adolescent↗
PubMedDate not supplied

Calorie and protein requirements of pediatric patients with acute nonlymphocytic leukemia.

The calorie and protein requirements wer studied in 6 pediatric patients with acute nonlymphocytic leukemia treated in a laminar air flow unit. Calorie and protein requirements were estimated from anthropometric data. Mean total caloric requirement for weight maintenance was 136% of estimated basal metabolic rate, which is much lower than the RDA for healthy children. The mean protein requirement was 108% RDA. Provision of intravenous nutrients depressed oral intake. Infection had a deleterious effect on visceral protein status as determined by serum albumin.

Acute Disease↗
PubMedDate not supplied

Use of Hickman right atrial catheter in pediatric oncology patients.

Eighteen pediatric oncology inpatients had 21 Hickman right atrial catheters placed for total venous access; 16 patients received parenteral nutrition. Mean duration of catheterization was 43 +/- 29 (SD) days. Four catheters had to be removed for infection or clotting. The catheter-related sepsis rate was 10%. Serious catheter-related complications were no more frequent in this population than in patients receiving only parenteral nutrition via Broviac or pediatric Broviac catheters.

Adolescent↗
PubMedDate not supplied

Hyperammonemia in neonates receiving intravenous nutrition.

Inadequate arginine intake has been suggested as an etiology for hyperammonemia in neonates on parenteral nutrition. We randomized 26 nonasphyxiated neonates to receive amino acid solutions containing either 3.6 or 10.4% of total nitrogen as arginine when intravenous nutrition (IVN) therapy was initiated. Neonates in both amino acid solution study groups were observed to have significantly elevated blood ammonia (BA) concentrations during IVN (p less than 0.01) as compared to pre-IVN levels. Blood ammonia concentrations tended to be higher in infants receiving the 3.6% arginine amino acid solution. Septic infants were at particular risk for hyperammonemia as compared to nonseptic patients (p less than 0.025). Other clinical parameters including birth weight, gestational age, oxygen requirements, enteral nutritional intake, congenital anomalies, and heart disease did not appear to be related to BA concentration.

Amino Acids↗