Background: Intrapyloric botulinum toxin injection (IPBI) is used to treat nausea and vomiting in children, but no prospective pediatric studies exist. The aims of the current study were to assess the efficacy of IPBI in children with refractory nausea or vomiting and to use EndoFLIP as a biomarker of IPBI response.
Methods: This was a prospective observational cohort study of pediatric patients undergoing IPBI for refractory nausea, vomiting, or feeding difficulties at a tertiary center. Patients completed validated questionnaires at baseline and 1, 2, and 3 months after IPBI. A subset of patients >10 years old underwent pyloric EndoFLIP at the time of IPBI. Symptoms were compared pre- and post-IPBI, and EndoFLIP measurements were assessed in relation to baseline characteristics and response to IPBI.
Key Results: Forty-five patients (mean age 14.2 ± 6.0 years) received IPBI, and 23 of those patients underwent EndoFLIP. Twenty-nine patients (64%) had symptomatic improvement at 1-month follow-up, including improvements in overall GI symptoms (p = 0.003), nausea and vomiting (p = 0.009), and discomfort when eating (p = 0.006). Symptomatic improvements lasted up to 3 months. There was a trend towards lower pyloric distensibility in patients with delayed versus normal gastric emptying (4.5 ± 3.8 mm /mmHg in delayed vs. 8.9 ± 6.6 mm /mmHg in normal, p = 0.09), though there were no differences in EndoFLIP measurements between IPBI responders and non-responders (p > 0.05).
Conclusions And Inferences: The majority of patients responded to IPBI, with significant improvements seen in nausea, vomiting, and discomfort. Pyloric EndoFLIP tended to distinguish baseline delays in gastric emptying, but it did not predict IPBI response in this patient cohort.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9648533 | PMC |
| http://dx.doi.org/10.1111/nmo.14428 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Incidence of adverse drug reactions among tuberculosis patients initiated on daily drug regimen in a southern district of Karnataka.
Perspect Clin Res
August 2024
Centre for Digital Health, Artificial Intelligence, Research and Training, Basaweshwara Medical College and Hospital, Chitradurga, Karnataka, India.
Aim: The study aimed to determine the incidence of adverse drug reactions (ADRs) among newly diagnosed tuberculosis (TB) patients receiving daily drug regimen with fixed-dose combination treatment under the National Tuberculosis Elimination Program.
Materials And Methods: A community-based prospective cohort study was carried out in the Udupi district. Over 12 months, all newly diagnosed TB patients of either gender were included from 63 primary health centers and 6 community health centers, and ADRs were recorded by personal interviews.
Hyperthyroidism in a Twin Pregnancy With a Hydatidiform Mole and a Coexisting Live Fetus: Management Dilemmas.
JCEM Case Rep
February 2025
Division of Endocrinology, McGill University Health Centre, Montréal, QC, Canada H4A 3J1.
Hyperthyroidism in twin pregnancies involving a hydatidiform mole and a coexisting live fetus is a rare condition requiring careful management. We present a 34-year-old pregnant woman at 12 weeks' gestation with severe nausea, vomiting, and mild vaginal bleeding. A transvaginal ultrasound revealed a dichorionic diamniotic twin pregnancy with 1 normal fetus and 1 hydatidiform mole, leading to hyperthyroidism from elevated β human chorionic gonadotropin levels.
View Article and Find Full Text PDFEffect of different doses of oral olanzapine to prevent postoperative nausea and vomiting after laparoscopic surgery in high-risk patients: A randomised controlled trial.
J Perioper Pract
January 2025
Department of Anaethesia, Intensive Care and Pain Management Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
Background: We conducted this study to compare the efficacy of oral 10 and 5 mg olanzapine for the prevention of postoperative nausea and vomiting.
Methods: Notably, 135 female patients between the ages of 18 and 50 years, classed as American Society of Anaesthesiologists I and II, who underwent elective laparoscopic gynaecological surgery under general anaesthesia were randomly assigned to one of three groups (45 each) to receive perioperative 5 or 10 mg oral olanzapine (OL5 and OL10 groups), or a placebo (in the control group). Postoperation, we recorded the occurrence and severity of postoperative nausea and vomiting within 24 h, the number of patients who received antiemetics and any associated side effects.
Effect of enhanced recovery after surgery on older patients undergoing transvaginal pelvic floor reconstruction surgery: a randomised controlled trial.
BMC Med
January 2025
Department of Gynaecology and Obstetrics, Women and Children's Hospital of Chongqing Medical University (Chongqing Health Center for Women and Children), Chongqing, China.
Background: Prospective trial evidence is lacking regarding the application of enhanced recovery after surgery (ERAS) in transvaginal pelvic floor reconstruction surgery among older patients. Our study aimed to investigate whether implementing the ERAS protocol could enhance post-operative recovery in this patient population.
Methods: Older patients undergoing elective transvaginal pelvic floor reconstruction surgery were randomly assigned to either the ERAS group or the conventional group.
Adjunct Ayurvedic treatment providing more than 10 years of disease-free survival in a rare case of male breast cancer patient with high-grade invasive ductal cell carcinoma - A Case Report.
J Ayurveda Integr Med
January 2025
Bharatiya Sanskriti Darshan Trust's Integrated Cancer Treatment and Research Centre, Wagholi, Pune, 412 207, Maharashtra, India.
Introduction: Male breast cancer (MBC) is an uncommon malignancy. In spite of conventional Allopathic treatment, long-term disease-free survival (DFS) of more than 10 years in MBC is rare, due to its aggressive nature.
Case Presentation: We report a case of 56 years old, stage IIB and grade III invasive ductal cell carcinoma MBC (Lt) patient, operated for left modified radical mastectomy with axillary clearance followed by six cycles of chemotherapy during October 2010-January 2011.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!