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Biomedical subjects

W A McCallion

Publications and source records attributed to W A McCallion.

At least 19 recordsLinked to original sources
PubMed1996

Antegrade colonic enemas.

Thirteen children aged 6-14 (mean 8) years in whom an antegrade colonic enema procedure was performed were reviewed retrospectively. All presented with refractory constipation or faecal soiling over a 3-year period. Nine of the children had previously undergone pull-through procedures for Hirschsprung's disease or high anorectal malformations. Two were suffering from spina bifida and two from idiopathic functional constipation. The operation was performed through a right iliac fossa incision. A catheterizable conduit was created. The appendix was brought out to the wound edge and made continent by intussuscepting the appendix base into the caecum. When the appendix was absent or unusable, a caecal tube was formed. Five patients suffered minor morbidity, six required a further operative procedure and two eventually required a sigmoid colostomy. However, the eventual outcome of a continent stoma was attained in 11 of the 13 children, all of whom would have been considered for sigmoid colostomy before introduction of the antegrade colonic enema procedure.

Adolescent↗
PubMed1996

Helicobacter pylori infection in children: relation with current household living conditions.

BACKGROUND: Studies demonstrating that deprived household living conditions during childhood are risk factors for acquisition of Helicobacter pylori infection have been performed mainly in adults, who probably acquired the infection several decades ago. This study investigates whether deprived household living conditions remain important risk factors for infection in subjects (children) with recently acquired infection. AIMS: To examine the relation between current household living conditions and acquisition of H pylori infection in childhood. SUBJECTS/SETTING: Opportunistically recruited group of 367 children, aged 3 to 15 years, undergoing routine non-gastrointestinal day surgery. METHODS: Anti-H pylori IgG antibodies measured by a commercial enzyme linked immunosorbent assay validated for use in children. Postal questionnaire collecting sociodemographic data and data on household living conditions. RESULTS: Infection was associated with social class and overcrowding in the household. After adjustment for age, social class, and household density, a positive association remained between infection with H pylori and bed-sharing between children and parents on one or two nights per week, odds ratio for infection (95% CI), 2.29 (1.21, 4.32) or more frequently, odds ratio for infection (95% CI), 2.95 (1.35, 6.45). CONCLUSIONS: The continuing importance of household living conditions in the acquisition of H pylori infection is confirmed and household crowding and sharing a bed with a parent are identified as risk factors for infection.

Adolescent↗
PubMed1995

Helicobacter pylori, hypergastrinaemia, and recurrent abdominal pain in children.

The association between Helicobacter pylori and recurrent abdominal pain (RAP) is controversial. In this cross-sectional study, the authors aim to determine whether hypergastrinaemia causes RAP in children with H pylori gastritis. In 439 children age 4 to 13 years (mean 7.3 years) attending for nongastrointestinal day-case surgery, anti-Helicobacter immunoglobulin G (IgG) was identified in serum by an enzyme-linked immunosorbent assay (ELISA) method validated in children and fasting plasma gastrin was measured. A history of RAP was sought. One hundred twenty-seven children (29%) tested seropositive for H pylori. Fifty-one seronegative children (16.3%) and 22 seropositive children (17.3%) gave a history of RAP. The mean fasting gastrin in seronegative children was 52 ng/L compared with 117 ng/L in seropositive children (P < .001). The mean fasting gastrin in seropositive children with RAP (124 ng/L) was not significantly different from that of seropositive children without RAP (115 ng/L). The high prevalence of H pylori seropositivity in this study is at variance with other reported paediatric data from the developed world. No association between childhood H pylori gastritis, hypergastrinaemia, and RAP was found. In children with H pylori gastritis, the increase in circulating gastrin (mean 140% increase) is greater than that seen in adults (50% increase).

Abdominal Pain↗
PubMed1995

Effect of general anaesthesia on prolonged intraoesophageal pH monitoring.

Investigation of gastro-oesophageal reflux often includes endoscopy, usually under general anaesthesia, and pH monitoring. In most cases, the pH probe is passed when the child is awake and is poorly tolerated. The effect of general anaesthesia on pH monitoring is unknown. The aim of the study was to determine if placing the probe in the anaesthetised child gives a representative pH study. Twenty children aged 4 months to 13 years underwent oesophago-gastroduodenoscopy under general anaesthesia. A pH electrode was placed under direct vision in the distal oesophagus. pH monitoring was begun after completion of anaesthesia and continued for 18-24 hours. The study was repeated within 14 days without anaesthetic. The reproducibility of values of percent pH < 4, number of reflux episodes/hour, reflux episodes lasting > 5 min, and longest reflux episode was 85%, 90%, 75%, and 75% respectively. These results are comparable with those in adults and children in whom pH studies were performed on consecutive days (without anaesthetic) keeping all variables constant. Therefore pH data collected in a child within 24 hours of endoscopy under general anaesthesia are representative.

Adolescent↗
PubMed1995

Age dependent hypergastrinaemia in children with Helicobacter pylori gastritis--evidence of early acquisition of infection.

Acute Helicobacter pylori associated gastritis causes achlorhydria, a powerful stimulus to gastrin secretion. If H pylori infection is acquired primarily in early childhood, then the degree of hypergastrinaemia in seropositive children should be age dependent. Anti-Helicobacter antibodies and fasting gastrin concentrations were measured in 439 children aged 4 to 13 years attending hospital for routine day case surgery not connected with any gastrointestinal disorder. Thirty per cent were seropositive for H pylori. There was an inverse relationship between the fasting gastrin concentration and age; the mean fasting gastrin in children aged 4-5 years, 155 ng/l, was significantly higher than that seen in children aged 12-13 years, 90 ng/l. The more noticeable hypergastrinaemia seen in young children with H pylori associated gastritis may reflect achlorhydria associated with acute H pylori infection and suggests that this is primarily acquired in early childhood.

Adolescent↗
PubMed1994

Acute appendicitis in young children in the Belfast urban area: 1985-1992.

Eighty-one cases of acute appendicitis in children aged less than six years were identified in the Belfast urban area between 1985 and 1992. Appendiceal perforation, found in 43%, was related to symptom duration but not to age at presentation. Prolongation of symptoms was related to parental delay in seeking medical advice (52% > 36 hours), delayed or inappropriate general practitioner referral to hospital (19%) and diagnostic delay following surgical consultation (12% > 12 hours). Diagnostic delay in hospital was usually the result of nonspecificity of symptoms and signs and was therefore largely unavoidable. Delayed referral from general practice did not contribute unnecessarily to appendiceal perforation, and given that an individual general practitioner will see a case of preschool appendicitis once in 30 years, diagnostic accuracy was remarkably high.

Appendectomy↗
PubMed1993

Paper colic.

Explore the source record for details and available documents.

Adolescent↗
PubMed1992

Prophylactic extrapleural chest drainage following repair of esophageal atresia: is it necessary?

In a review of 110 cases of esophageal atresia (EA) and tracheoesophageal fistula (TEF), 15 patients (13.6%) developed anastomotic leakage. All patients had extrapleural surgical exposure and prophylactic extrapleural chest drainage (PEPCD). Despite this precaution, all patients with anastomotic leaks developed a pneumothorax with or without a pleural effusion. This required insertion of an additional drain in 12 (80%) cases. PEPCD following repair of EA and TEF does not appear to prevent pneumothorax or pleural effusion when anastomotic leakage occurs.

Drainage↗
PubMed1992

Chronic organoaxial malrotation of the stomach in childhood.

During a six-month period five patients presented to The Royal Belfast Hospital for Sick Children between the ages of three weeks and three years with recurrent vomiting and failure to thrive. All were diagnosed as having organoaxial malrotation of the stomach by barium meal examination. Symptoms were refractory to conservative management but combined gastropexy and fundoplication was successful in all cases.

Child, Preschool↗