Symptomatic gastric inlet patches in children treated with argon plasma coagulation: a case series.

The pathologic potential of gastric inlet patches is now being recognized. A recent adult study has shown the effectiveness of argon plasma coagulation in ablating the patch and the associated symptoms. There are no reports of ablation in children.

Tolerance of an enteral formula with insoluble and prebiotic fiber in children with compromised gastrointestinal function.

The effects of adding fiber to the tolerance of a peptide-based formula have not been studied. The objective of this study was to evaluate the tolerance of a peptide-based formula with insoluble and prebiotic fiber in children with compromised gut function. During January 2005 to June 2006, a 6-week randomized, double-blind, cross-over clinical study was conducted to compare stool frequency, stool consistency, and tolerance (abdominal pain, abdominal distension, vomiting, weight gain, and intake) between a formula with or without 3.

Bronchial hyperreactivity in non-atopic children with asthma and reflux: effect of anti-reflux treatment.

Introduction: The prevalence of bronchial hyperreactivity (BHR) or the effect of anti-reflux treatment on BHR in children with asthma and gastroesophageal reflux disease (GERD) is not known.

Methods: Thirty non-atopic children with persistent asthma were studied. Extended esophageal pH monitoring was used to diagnose GERD and methacholine challenge test (MCT) was used as a marker of BHR and performed before and 2 years after anti-GERD treatment.

Associated factors in children with chronic cough.

Background: Children presenting with chronic cough are common to the primary care physicians, but data on the etiology are scant.

Methods: We evaluated 40 children (age range, 5 to 12 years) with chronic cough (> 8 weeks duration) with no obvious cause who were referred by their primary care physicians. All patients underwent an extensive multispecialty workup that included pulmonary, GI, allergy, immunology, and otorhinolaryngology testing.

Clinical response to 2 dosing regimens of lansoprazole in infants with gastroesophageal reflux.

Proton pump inhibitors such as lansoprazole are used in the treatment of gastroesophageal reflux disease (GERD), but dosing guidelines for infants have not been determined. The objective of this study was to assess the clinical efficacy of 2 dosing regimens of lansoprazole in infants with GERD using the revised infant gastroesophageal reflux questionnaire scores (I-GERQ-R). Thirty consecutive infants (3-7 months) with GERD, whose conditions were diagnosed by I-GERQ-R scores of > or =16, were randomly assigned to receive 1 of 2 lansoprazole dosing regimens: 15 mg given once per day (group A) or approximately 7.

Are we overprescribing antireflux medications for infants with regurgitation?

Objective: Our goal was to evaluate the diagnosis and treatment of infants with persistent regurgitation who were referred to a pediatric gastroenterology service.

Methods: The records of 64 infants with persistent regurgitation and without any neurodevelopmental abnormalities, underlying illness, or cigarette smoke exposure were evaluated for diagnostic workup and treatment. Forty-four infants underwent extended esophageal pH monitoring.

Effect of antireflux treatment on asthma exacerbations in nonatopic children.

Objective: To evaluate the asthma outcome of treatment with ranitidine or esomeprazole plus metoclopramide in older children with moderate-persistent asthma and gastroesophageal reflux disease (GERD).

Patients And Methods: The study patients included 44 patients with asthma and GERD who had received 1 year of treatment with a proton pump inhibitor/prokinetic combination and had shown significant clinical improvement in asthma symptoms and no exacerbations for more than 3 months. For further treatment, 30 of the 44 patients continued treatment with esomeprazole/metoclopramide (group A), and 14 switched to ranitidine (group B).

Gastroesophageal reflux disease and asthma in children.

Gastroesophageal reflux disease (GERD) occurs in about two thirds of children with asthma. It may simply represent a concomitant unrelated finding or it may be responsible for provoking or worsening asthma. GERD could also be a byproduct of asthma itself.

Effect of a laxative with and without tegaserod in adolescents with constipation predominant irritable bowel syndrome.

Aim: To determine the effect of a laxative alone and in combination with tegaserod in alleviating pain and improving stool frequency in adolescents with constipation predominant irritable bowel syndrome.

Patients: Forty-eight postpubertal adolescents of both sexes with constipation predominant irritable bowel syndrome, as defined by Rome II criteria, were randomly allocated to Group A (n = 27) for treatment with a laxative (polyethylene glycol 3350 oral solution) only or Group B (n = 21) for combination therapy with the laxative and tegaserod. Symptoms of abdominal pain (scale 0-10) and frequency of bowel movements were recorded daily in the pre-treatment phase and the post-treatment phase after a 7-day 'washout' period.

Difficulty in defecation in infants with gastroesophageal reflux treated with smaller volume feeds thickened with rice cereal.

We prospectively evaluated the incidence of difficulty in defecation in infants with gastroesophageal reflux who were treated with smaller volume feeds thickened with rice cereal and also assessed the effect of changing the cereal to oatmeal. We evaluated 53 thriving infants with uncomplicated gastroesophageal reflux who were treated with smaller volume feeds thickened with rice cereal. Parents maintained records of bowel movements for 7 days.

Propofol versus midazolam plus meperidine for sedation during ambulatory esophagogastroduodenoscopy.

Objective: To evaluate the efficacy and safety of propofol and meperidine plus midazolam for sedation during esophagogastroduodenoscopy (EGD) in children.

Methods: Data were collected prospectively and retrospectively from neurologically intact children (0.2-17.

Ethiopian-born and native Israeli school children have different growth patterns.

Objective: Nutrition status of preschool children in Azezo, North West Ethiopia, and Ethiopian-born and native Israeli children aged 7 to 11 y and 12 to 15 y was studied. The aim of the study was to determine the growth patterns of immigrant children after changes in their nutritional habits.

Methods: The Ethiopian-born and native school children were recruited from a caravan-dwelling site and a boarding school and from a town adjacent to the caravan site and a boarding school, respectively.

Role of gastroesophageal reflux in older children with persistent asthma.

Background: Gastroesophageal reflux (GER) plays a role in inducing or exacerbating asthma.

Methods: We evaluated asthma outcome before and after anti-GER treatment in older children (age range, 5 to 10.5 years) who had persistent moderate asthma and were being treated with short- and long-acting bronchodilators, inhaled corticosteroids, and leukotriene antagonists.

Early ribavarin treatment of bronchiolitis: effect on long-term respiratory morbidity.

Background: The mortality rate from respiratory syncytial virus (RSV) bronchiolitis has significantly reduced over the last decade. A major concern now is the long-term respiratory morbidity following RSV bronchiolitis.

Methods: In this prospective study, we randomly assigned 49 previously healthy infants with severe RSV bronchiolitis, early in the course of illness (< 5 days duration), to receive either conservative treatment (n = 21) or additional ribavirin treatment (n = 24).

Use of energy-dense formula for treating infants with non-organic failure to thrive.

Objective: To evaluate if simply increasing the energy density of the formula will lead to increased energy intake and weight gain in infants with non-organic failure to thrive.

Design: In this hospital-based trial, 15 infants (mean age, 7.6+/-1.

Gastric emptying of two whey-based formulas of different energy density and its clinical implication in children with volume intolerance.

Objective: Whey-based formulas have faster gastric emptying than casein-based formulas. Isoenergetic, isovolumic, whey-based formulas of different osmolarity and fat content empty in a similar manner. Will the gastric emptying of high and low energy density whey-based formulas be similar?

Design: We studied the gastric emptying rate of equal volumes of two whey-based formulas of different energy density (4.

Aspiration: a factor in rapidly deteriorating bronchiolitis in previously healthy infants?

The objective of this study was to evaluate the presence of indicators of aspiration in previously healthy infants with respiratory syncytial viral (RSV) bronchiolitis who experienced rapid deterioration in their respiratory status. Lipid-laden macrophage index (LLMI) was assessed in 6 previously healthy infants with RSV bronchiolitis and no prior history of aspiration, who had a rapid deterioration of their respiratory status requiring mechanical ventilation. Five of 6 infants had a LLMI of more than 100, a level that is very suggestive of aspiration.

Benefits of thickened feeds in previously healthy infants with respiratory syncytial viral bronchiolitis.

Infants with respiratory syncytial virus (RSV) bronchiolitis have an increased risk of aspiration. The optimal feeding strategy for these patients has not been described. Fifteen previously healthy and clinically stable infants with RSV bronchiolitis underwent video-fluoroscopy studies to assess swallowing using thin barium.

Smaller volume, thickened formulas in the management of gastroesophageal reflux in thriving infants.

Background: The effect of smaller volume, thickened formulas on gastroesophageal reflux is not clear.

Methods: The frequency of gastroesophageal reflux and duration of acid pH in the esophagus were determined in six thriving infants using extended esophageal pH monitoring.

Results: There was a significant reduction in frequency of emesis and gastroesophageal reflux but not the duration of acid pH in the esophagus with the use of infant formula thickened with rice cereal to provide a nutritionally appropriate intake in a smaller volume.

Effect of cisapride on the QT interval in infants with gastroesophageal reflux.

Objective: We prospectively studied the effect of cisapride per se on QT interval in young infants (3-6 months) with gastroesophageal reflux (GER) in a controlled setting.

Study Design: The infants diagnosed with GER and deemed to require therapy with cisapride were divided into 2 groups. Group A comprised infants with GER who underwent an electrocardiogram (ECG) before initiation of therapy with cisapride in the dose of 1 mg per kg per 24 hours, divided into 3 doses.

Previously healthy infants may have increased risk of aspiration during respiratory syncytial viral bronchiolitis.

Objective: Respiratory illnesses may cause feeding difficulties in infants. We studied the safety of oral feeding during respiratory syncytial viral (RSV) bronchiolitis in previously healthy infants.

Methods: Twelve previously healthy infants (3-12 months) with RSV bronchiolitis underwent barium swallow studies during the acute phase of illness.

Effect of parenteral nutrition on oral intake.

Oral intake following a high density oral supplement (preload) is lower than that after a low density preload. We studied a similar effect of parenteral nutrition on oral intake. Twelve neurologically intact children (8-16 yr) with orthopedic problems and no concurrent illness were included in the study.

Nutrition and swallowing in pediatric neuromuscular patients.

The management of the patient with neuromuscular disease is complex. Every child should be seen as a distinct individual and therefore merits patient-specific assessment and intervention. This article reviews nutritional management using spinal muscular atrophy and Duchenne's muscular dystrophy as representative models.