Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 133
Filtrar
1.
Gastroenterol Res Pract ; 2011: 491035, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21811496

RESUMEN

Helicobacter pylori infection, often acquired in early childhood, is a global cause of undernutrition, gastritis, peptic ulcer disease and gastric carcinoma. This study tested the feasibility of using H. pylori shed in the faeces as a source of DNA for non-invasive epidemiological studies. H. pylori DNA was chemically recovered and isolated using a specific biotinylated oligonucleotide probe with magnetic capture from 28 H. pylori positive faecal samples obtained from children attending hospital for the investigation of suspected H. pylori infection, together with close family members. Random amplification of polymorphic DNA (RAPD) was subsequently used to discriminate each isolate. 93% of stool samples selected were typeable. Parent, child and sibling samples were compared and similarities determined. Phylogenetic analysis showed that H. pylori DNA obtained from the faeces can be used to genotype individual strains, offering a means of studying intrafamilial transfer of this microorganism.

2.
Eur J Clin Nutr ; 65(1): 3-9, 2011 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21119695

RESUMEN

The rates and patterns of growth in weight of European and North American infants have changed over the last 100 years. Since the development and first use of growth charts for postnatal health surveillance a century ago, there appears to have been an increase in the weight of 1-year olds of about 1 kg. Taking into account the higher past rates of infant morbidity and mortality, and poorer quality of artificial feeds, this change is likely to be another expression of the secular increase in physical stature consequent on improved hygiene and nutrition. Using the new WHO (World Health Organisation) standards of infant weight growth, this secular change can be observed for both breast-fed and formula-fed babies. The slower weight growth of the former, both now and in the past compared with modern formula-fed babies, may have implications of our understanding of the risk factors for obesity and cardiovascular disease. The variability of infant growth in time and space, and the plasticity of developmental processes during the life course (fetal life, infancy, puberty and reproduction), means that the WHO infant growth standard should not alone be regarded as an ideal growth trajectory for all babies.


Asunto(s)
Desarrollo Infantil , Gráficos de Crecimiento , Fenómenos Fisiológicos Nutricionales del Lactante , Bienestar del Lactante/historia , Factores de Edad , Lactancia Materna , Europa (Continente) , Historia del Siglo XX , Humanos , Lactante , Fenómenos Fisiológicos Nutricionales del Lactante/historia , América del Norte , Obesidad/epidemiología , Organización Mundial de la Salud
3.
Aliment Pharmacol Ther ; 33(2): 175-84, 2011 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21091524

RESUMEN

BACKGROUND: Intestinal failure (IF) affects a growing number of children due to increasing numbers of preterm infants surviving intestinal resection for necrotising enterocolitis and improving surgical techniques for congenital gut anomalies. Parenteral nutrition (PN) is the mainstay of therapy; enteral nutrition may have trophic effects on the gut. AIM: To review systematically evidence for the effectiveness of medical and nutritional interventions in the treatment of IF in children. METHODS: Retrieval of data from studies of patients aged <18 years and receiving >28 days of PN. Outcome measures were improvement in intestinal function, intestinal adaptation, growth, prevention and treatment of IF-associated liver disease, and mortality. Cochrane Database (November 2009), MEDLINE (1950-November 2009) and CINAHL (1982-November 2009) electronic database searches were made using keyword and subject headings (MeSH): IF, Short Bowel Syndrome (SBS), PN and Child. The level of the evidence (EL) was assessed using SIGN (Scottish Intercollegiate Guidelines Network) methodology (http://www.sign.ac.uk). RESULTS: From 1 607 620 hits, 720 abstracts were reviewed. Thirty-three original articles were included. No studies were of high methodological quality. CONCLUSIONS: The evidence base for medical and nutritional interventions in paediatric IF is limited and of poor quality. In the absence of randomised-controlled trials, this evidence base can improve through case control and cohort research; and with better multiagency communication, the study of inter-centre differences is possible. Achievable short-term goals would include the study of: optimal ursodeoxycholic usage, novel intralipid formulations, cycled enteral antibiotics, enteral probiotics and new enteral feeding strategies.


Asunto(s)
Nutrición Enteral/métodos , Enfermedades Gastrointestinales/terapia , Intestinos/cirugía , Nutrición Parenteral/métodos , Adolescente , Niño , Preescolar , Enfermedades Gastrointestinales/complicaciones , Humanos , Lactante , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
4.
Arch Dis Child ; 94(9): 708-12, 2009 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-19329443

RESUMEN

Maternal drug misuse can seriously affect the health of the fetus and newborn infant. The association of maternal drug misuse with prematurity, intrauterine growth restriction (IUGR) and neonatal abstinence syndrome (NAS) is well recognised, and there is growing concern about infant visual development and longer-term neurodevelopmental outcome. Drug misuse is associated with changes in the visual system as measured by the visual evoked potential (VEP) in adults and animal models. A recent study has shown abnormal VEPs in newborn infants exposed to methadone in utero, consistent with reports of delayed visual development in this population. Since visual abnormalities and neurodevelopmental abnormalities can be predicted by abnormal VEPs in infancy, it is postulated that the VEP may be a valuable tool in the detection of the adverse effects of maternal drug misuse upon the infant. This review summarises the impact of maternal drug misuse upon the health of the fetus and newborn infant, addresses the specific effects of maternal drug misuse upon the developing visual system and discusses the potential role of the VEP in the assessment of these infants.


Asunto(s)
Desarrollo Infantil/efectos de los fármacos , Consumidores de Drogas , Madres , Efectos Tardíos de la Exposición Prenatal , Adulto , Electroencefalografía , Potenciales Evocados Visuales/efectos de los fármacos , Femenino , Humanos , Recién Nacido , Neurogénesis/efectos de los fármacos , Embarazo , Visión Ocular/efectos de los fármacos , Adulto Joven
6.
J Pediatr Gastroenterol Nutr ; 48(2): 161-7, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19179877

RESUMEN

OBJECTIVES: To determine anti-Saccharomyces cerevisiae antibodies (ASCA) status and its relation to disease phenotype in patients with inflammatory bowel disease (IBD). PATIENTS AND METHODS: A total of 301 Scottish patients with early-onset IBD-197 Crohn disease (CD), 76 ulcerative colitis (UC), 28 indeterminate colitis (IC)-and 78 healthy control individuals were studied. ASCA status (IgA, IgG) was determined by enzyme-linked immunosorbent assay. ASCA status was then analyzed in relation to CD phenotype. RESULTS: Patients with CD had a higher prevalence of ASCA than patients with UC and healthy controls: 82/197 versus 12/76, odds ratio (OR) 3.80 (1.93-7.50) and 82/197 versus 6/78, OR 8.56 (3.55-20.62), respectively. Univariate analysis showed that positive ASCA status was associated with oral CD (17/25 vs 59/153, OR 3.39 [1.38-8.34]), perianal CD (39/77 vs 38/108, OR 1.89 [1.04-3.44]) and the presence of granulomata (63/132 vs 15/52, OR 2.25 [1.13-4.48]) and also with markers of disease severity: raised C-reactive protein (44/90 vs 12/49, OR 2.95[1.36-6.37]), hypoalbuminemia (44/85 vs 20/74, OR 2.28[1.19-4.37]), and surgery (27/49 vs 54/147, OR 2.11 [1.10-4.06]). From multivariate analysis, the presence of oral disease (adjusted P = 0.001, OR 22.22 [3.41-142.86]) and hypoalbuminemia (adjusted P = 0.01, OR 4.78 [1.40-16.39]) was found to be independently associated with ASCA status. No association was demonstrated between ASCA and IBD candidate genes. CONCLUSIONS: Patients with CD had a higher prevalence of ASCA than did other patients with IBD. ASCA status described patients with CD who had a specific phenotype, showing an association with markers of disease severity and oral CD involvement.


Asunto(s)
Anticuerpos Antifúngicos/sangre , Colitis Ulcerosa/inmunología , Enfermedad de Crohn/inmunología , Saccharomyces cerevisiae/inmunología , Adolescente , Biomarcadores/sangre , Estudios de Casos y Controles , Niño , Colitis Ulcerosa/sangre , Colitis Ulcerosa/microbiología , Colitis Ulcerosa/patología , Enfermedad de Crohn/sangre , Enfermedad de Crohn/microbiología , Enfermedad de Crohn/patología , Ensayo de Inmunoadsorción Enzimática , Femenino , Genotipo , Estado de Salud , Humanos , Inmunoglobulina A/sangre , Inmunoglobulina G/sangre , Masculino , Análisis Multivariante , Oportunidad Relativa , Estudios Seroepidemiológicos , Índice de Severidad de la Enfermedad
7.
J R Coll Physicians Edinb ; 38(2): 179-86, 2008 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-18831118

RESUMEN

Laura Smith was sister-in-charge of the Children's Dispensary in Glasgow from 1897 to 1922. In 1911 she established Sister Laura's Infant Food Company to market a special milk formula of her own invention.The directors of the Dispensary were not amused. As the 'outdoor' department of the Royal Hospital for Sick Children (Yorkhill), the Dispensary was at the forefront of efforts to combat child ill health and malnutrition. This paper considers Laura Smith's initiative within the context of the health and care of infants of the time - high infant mortality, public and professional concerns for infant welfare, technological advances in food science, changing recommendations and practices of infant feeding and ambiguous relations between medicine and commerce.


Asunto(s)
Servicios de Salud del Niño/historia , Obtención de Fondos/historia , Alimentos Infantiles/historia , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Lactante , Recién Nacido , Escocia
8.
Inflamm Bowel Dis ; 14(3): 338-46, 2008 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-18088053

RESUMEN

BACKGROUND: The rs2241880A/G variant of the ATG16L1 gene has been associated with susceptibility to ileal Crohn's disease (CD) in adults. Our aim was to assess whether germline variation of ATG16L1 acts as an independent determinant of susceptibility to childhood-onset CD in the high-incidence Scottish population. METHODS: In all, 2195 subjects (361 children (inflammatory bowel disease [IBD] diagnosis <17 years), their parents (n = 634), 855 adult IBD patients, and 345 controls were genotyped. Case-control analysis was powered to detect effect sizes with an odds ratio (OR) >1.39 in pediatric CD. Case-control analysis, transmission disequilibrium testing (TDT), analysis of variance (ANOVA) of growth parameter z-scores, Kruskal-Wallis test (age at diagnosis), and multifactorial genotype-phenotype analysis (Montreal classification) were performed. 7.8% of pediatric CD patients and 37.2% of adult CD patients had pure ileal disease. RESULTS: We confirmed the association of the rs2241880G-allele with adult-onset CD (60.7% versus controls 53.9%, P = 0.01, OR 1.32, 95% confidence interval [CI] 1.07-1.63) in contrast to childhood-onset CD (54.1% versus controls, P = 0.95, OR 1.01, 95% CI 0.80-1.26). TDT analysis was negative. Genotype-phenotype analysis demonstrated an association of pure ileal disease with the rs2241880G-allele (P = 0.02, OR 1.34, 95% CI 1.03-1.74). Using binary logistic regression analysis we confirmed the effect of rs2241880 genotype (GG) on ileal disease versus colonic disease (P = 0.03, OR 2.43, 95% CI 1.05-5.65). ATG16L1 genotype did not influence age at CD diagnosis. ANOVA of z-scores of height, weight, and body mass index (BMI) at CD diagnosis in children showed no association with genotype. CONCLUSIONS: The ATG16L1 variant is associated with susceptibility to adult CD in Scotland, but not early-onset disease. These contrasting effects are primarily driven by differences in disease location between early-onset and adult-onset disease.


Asunto(s)
Proteínas Portadoras/genética , Enfermedad de Crohn/epidemiología , Enfermedad de Crohn/genética , ADN/genética , Predisposición Genética a la Enfermedad/epidemiología , Polimorfismo Genético , Adolescente , Adulto , Edad de Inicio , Alelos , Proteínas Relacionadas con la Autofagia , Estudios de Casos y Controles , Niño , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad/genética , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Proteína Adaptadora de Señalización NOD2/genética , Oportunidad Relativa , Fenotipo , Escocia/epidemiología
9.
J Pediatr ; 150(3): 268-73, 2007 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-17307543

RESUMEN

OBJECTIVE: To assess the contribution of the 113 G-->A missense mutation within the discs, large homolog 5 (DLG5) gene in childhood-onset inflammatory bowel disease (IBD) in Scotland. STUDY DESIGN: Two-hundred and ninety-six children with IBD were studied. Parental DNA was also collected for transmission disequilibrium testing (TDT) analysis. Genotyping was performed by TaqMan. Genotype-phenotype analysis was also undertaken. Socioeconomic status was assigned using a deprivation category (DepCat) score 1 through 7 (1 = most affluent). RESULTS: TDT analysis demonstrated a significant association with IBD (P = .045). On unifactorial analysis, 113A carriage was associated with: (1) higher social class (DepCat 1 compared with 2-7, and 1-2 compared with 3-7) (66.7% vs 22.6%, P = .0005, OR 6.84 [1.99-23.55] and 37.2% vs 22.2%, P = .03, OR 2.08 [1.04-4.17], respectively); (2) higher height centile (>75th centile vs <75th centile) (42.9% vs 23.1%, P = .01, OR 2.50 [1.18-5.28]); and (3) male sex in Crohn's disease (CD) (29.3% vs 16.9%, P = .04, OR 2.04 [1.01-4.11]). Multifactorial analysis demonstrated that higher social class (DepCat 1) was independently associated with carriage of variants of 113A (P = .001, OR = 6.92 [2.24-21.33]). CONCLUSIONS: DLG5 113A is associated with increased susceptibility to IBD in Scottish children. The effect may be most marked for those children living in relative affluence.


Asunto(s)
Predisposición Genética a la Enfermedad/epidemiología , Enfermedades Inflamatorias del Intestino/epidemiología , Enfermedades Inflamatorias del Intestino/genética , Proteínas de la Membrana/genética , Mutación Missense , Proteínas Supresoras de Tumor/genética , Adolescente , Edad de Inicio , Niño , Preescolar , Estudios de Cohortes , Femenino , Regulación de la Expresión Génica , Heterocigoto , Humanos , Incidencia , Enfermedades Inflamatorias del Intestino/fisiopatología , Modelos Logísticos , Masculino , Oportunidad Relativa , Linaje , Fenotipo , Probabilidad , Pronóstico , Escocia/epidemiología , Índice de Severidad de la Enfermedad
10.
Inflamm Bowel Dis ; 13(7): 882-9, 2007 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-17285593

RESUMEN

BACKGROUND: NOD1/CARD4 and NOD2/CARD15 are both intracellular pattern-recognition receptors. The NOD1/CARD4 gene lies within a previously described inflammatory bowel disease (IBD) locus (7p14). An association has been suggested between the NOD1/CARD4+32656 deletion*1 variant of a complex deletion*1/insertion*2 polymorphism and IBD in 1 recent study in Europe. Our aim was to assess the influence of NOD1/CARD4+32656 on disease susceptibility and phenotype in the Scottish and Swedish IBD populations. METHODS: A total of 3,962 individuals (1,791 IBD patients, 522 parents, 1,649 healthy controls) from 2 independent populations (Scotland and Sweden) were genotyped for NOD1/CARD4+32656 A/C by TaqMan and direct sequencing. Case-control, Transmission Disequilibrium Testing (TDT) and detailed genotype-phenotype (Montreal) analyses were performed. The case-control analysis had 80% power to detect an effect size of odds ratio (OR) 1.21 for IBD. RESULTS: In case-control analyses in Scottish and Swedish patients, none of the genotypes studied in IBD, Crohn's disease (CD) or ulcerative colitis (UC), differed significantly from controls (deletion*1 allelic frequency 73.9%, 73.6%, 73.9%, and 73.6%, respectively: all P > 0.8). No epistatic interaction with NOD2/CARD15 was seen for CD susceptibility. TDT analysis in our Scottish early onset cohort was negative. CONCLUSIONS: This variant allele of NOD1/CARD4+32656 is not associated with a strong effect on susceptibility to IBD in children and adults in Northern Europe. A gene-wide haplotype-based approach may be preferable to analysis of individual variants to assess the contribution of the NOD1/CARD4 gene to IBD.


Asunto(s)
Predisposición Genética a la Enfermedad , Enfermedades Inflamatorias del Intestino/genética , Mutación , Proteína Adaptadora de Señalización NOD1/genética , Adolescente , Adulto , Edad de Inicio , Estudios de Casos y Controles , Niño , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Fenotipo , Polimorfismo Genético , Escocia , Suecia
11.
J Pediatr Endocrinol Metab ; 20(12): 1315-24, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-18341091

RESUMEN

BACKGROUND/AIMS: The efficacy of recombinant human growth hormone (rhGH) in treating the growth failure associated with Crohn's disease (CD) is unclear. METHODS: Retrospective data analysis at 12 months before (T-12), 6 months before (T-6), at baseline (T+0), 6 months after (T+6) and 12 months after (T+12) rhGH treatment in seven patients with CD (five males). RESULTS: Median chronological age (CA) and median difference between CA and bone age was 15.9 yr (range, 13.0 to 17.9) and 1.7 yr (-0.7 to 3.3), respectively. Median dose of rhGH at T+0 was 0.23 mg/wk (0.15 to 0.31). Pubertal status remained unchanged in 6/7 patients. Median albumin and C-reactive protein (CRP) were similar at T+0 and T+6. Median height SDS at T+0, T+6 and T+12 was -2.2 (-4.0 to -1.5), -1.9 (-4.1 to -0.8), -1.9 (-4.1 to -0.7), respectively (NS). Median height velocity (HV) SDS at T+0 and T+6 was -2.5 (-4.8 to 1.4) and -0.9 (-5.3 to 3.4), respectively (NS). There was a positive correlation between percentage change in HV SDS at T+6 and dose of rhGH at T+0 (r = 0.8, p = 0.03). CONCLUSION: Introduction of rhGH therapy was associated with a cessation in the deterioration in linear growth. However, an improvement in height SDS was not observed over the period of the study. Future studies should explore the efficacy of a higher dose of rhGH in CD.


Asunto(s)
Estatura/efectos de los fármacos , Enfermedad de Crohn/tratamiento farmacológico , Trastornos del Crecimiento/tratamiento farmacológico , Hormona de Crecimiento Humana/uso terapéutico , Proteínas Recombinantes/uso terapéutico , Administración Oral , Adolescente , Determinación de la Edad por el Esqueleto/métodos , Factores de Edad , Anticuerpos Monoclonales/uso terapéutico , Proteína C-Reactiva/análisis , Niño , Enfermedad de Crohn/fisiopatología , Relación Dosis-Respuesta a Droga , Glucocorticoides/administración & dosificación , Glucocorticoides/uso terapéutico , Trastornos del Crecimiento/sangre , Trastornos del Crecimiento/fisiopatología , Hormona de Crecimiento Humana/administración & dosificación , Hormona de Crecimiento Humana/genética , Humanos , Infliximab , Inyecciones Subcutáneas , Masculino , Metotrexato/administración & dosificación , Metotrexato/uso terapéutico , Examen Físico/métodos , Pubertad/fisiología , Proteínas Recombinantes/administración & dosificación , Estudios Retrospectivos , Albúmina Sérica/análisis , Factores de Tiempo , Resultado del Tratamiento
12.
Clin Infect Dis ; 43(8): 1040-2, 2006 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-16983617

RESUMEN

We collected data, including the weights, urea breath test results, and presence of maternal milk cytotoxin-associated gene-specific and vacuolating cytotoxin A-specific immunoglobulin A monthly from 48 mothers and infants (to 44 weeks of age) in The Gambia. In all, 11 children (23%) had negative urea breath test results, and 37 (77%) had positive results. Weight loss associated with Helicobacter pylori colonization was restricted to children whose mothers did not produce anti-vacuolating cytotoxin A antibodies in their milk (P=.028, by t test).


Asunto(s)
Antígenos Bacterianos/inmunología , Proteínas Bacterianas/inmunología , Infecciones por Helicobacter/inmunología , Helicobacter pylori/inmunología , Leche Humana/inmunología , Adulto , Femenino , Gambia , Helicobacter pylori/patogenicidad , Humanos , Lactante , Recién Nacido , Leche Humana/microbiología
13.
QJM ; 99(8): 497-503, 2006 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-16880184

RESUMEN

Black Death and AIDS are global pandemics that have captured the popular imagination, both attracting extravagant hypotheses to account for their origins and geographical distributions. Medical scientists have recently attempted to connect these two great pandemics. Some argue that the Black Death of 1346-52 was responsible for a genetic shift that conferred a degree of resistance to HIV 1 infection, that this shift was almost unique to European descendents, and that it mirrors the intensity of Black Death mortality within Europe. Such a hypothesis is not supported by the historical evidence: the Black Death did not strike Europe alone but spread from the east, devastating regions such as China, North Africa, and the Middle East as much or even more than Europe. Further, in Europe its levels of mortality do not correspond with the geographic distribution of the proportion of descendents with this CCR5 gene. If anything, the gradient of Black Death mortality sloped in the opposite direction from that of present-day genotypes: the heaviest casualties were in the Mediterranean, the very regions whose descendents account for the lowest incidences of the HIV-1 resistant allele. We argue that closer collaboration between historians and scientists is needed to understand the selective pressures on genetic mutation, and the possible triggers for changes in genetic spatial frequencies over the past millennia. This requires care and respect for each other's methods of evaluating data.


Asunto(s)
Infecciones por VIH/genética , VIH-1 , Peste/genética , Peste/historia , Receptores CCR5/genética , Brotes de Enfermedades , Europa (Continente)/epidemiología , Predisposición Genética a la Enfermedad , Infecciones por VIH/epidemiología , Historia Medieval , Humanos , Peste/epidemiología
14.
Scott Med J ; 51(3): 26-9, 2006 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-16910048

RESUMEN

BACKGROUND AND AIMS: Dental decay remains a major public health problem in Scottish children. The aim of this study was to investigate the relationship between diet, bowel habit, social class, and body mass index (BMI) in children with severe tooth decay. CHILDREN AND METHODS: A cross sectional study of 165 children aged 3 -11 years attending Glasgow Dental Hospital for extraction of teeth under dental general anaesthesia (DGA), was undertaken. A structured questionnaire was used to obtain information from each child on diet, bowel habit, and social status of their parents. Fibre and sugar scores were calculated from the frequency of consumption of a range of relevant foods. RESULTS: The children (mean age 5.7 (SD1.8) years) had between 1 and 20 decayed, missing or filled primary teeth (dmft) with a mean dmft of 7.9 (SD 3.5). 37% ate a chocolate bar daily, and 29% regularly drank a sugary drink after brushing their teeth. An excess of children were from the most deprived parts of the city and they had the worst decay. Children with the worst decay were also significantly thinner. No relationship was found between tooth decay and bowel habit. CONCLUSIONS: In this selected group of children with poor dental health, those from deprived families were over-represented and had significantly more decay. Severe dental decay was also associated with underweight.


Asunto(s)
Caries Dental , Dieta , Índice de Masa Corporal , Niño , Preescolar , Estudios Transversales , Caries Dental/epidemiología , Sacarosa en la Dieta/administración & dosificación , Humanos , Clase Social , Factores Socioeconómicos
15.
Eur J Clin Nutr ; 60(11): 1245-52, 2006 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-16736067

RESUMEN

BACKGROUND: The [13C]mixed triacylglycerol (MTG) breath test is a non-invasive measure of fat digestion and can be used to assess the need for enzyme replacement therapy in children with cystic fibrosis (CF). However, it lacks specificity. Quantitation of cumulative percent dose recovered (cPDR) requires knowledge of carbon dioxide production rate (VCO2). A resting value is assumed, but children are unlikely to remain at rest during the test. OBJECTIVE: To improve the specificity and therefore the positive predictive value (PPV) of the MTG breath test using calibrated heart rate monitors to estimate non-resting VCO2. DESIGN: Proof of concept study. SUBJECTS: Six children with CF, 10 healthy children and eight healthy adults performed [13C]MTG breath tests. METHODS: Heart rate monitors were worn throughout the test. Non-resting VCO2 was estimated continuously from heart rate. Percentage dose recovered was calculated using predicted resting VCO2, measured resting VCO2 and non-resting VCO2 estimated from heart rate. Physical activity level (PAL) was taken as cPDR calculated using non-resting VCO2 divided by cPDR calculated using measured resting VCO2. The cutoff point was determined using two graph-receiver operator characteristics. RESULTS: Use of calibrated heart rate monitors to estimate non-resting VCO2 improved the specificity of the test. The PPV increased from 0.67 to 0.99. PAL was 1.3 in adults and children who performed the test in hospital, and 1.7 in children who performed the test at home. CONCLUSION: Individually calibrated heart rate monitors are useful tools to estimate non-resting VCO2 during the [13C]MTG breath test.


Asunto(s)
Pruebas Respiratorias , Dióxido de Carbono/análisis , Fibrosis Quística/metabolismo , Grasas de la Dieta/metabolismo , Frecuencia Cardíaca/fisiología , Adolescente , Adulto , Metabolismo Basal/fisiología , Calibración , Isótopos de Carbono , Niño , Preescolar , Fibrosis Quística/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Consumo de Oxígeno/fisiología , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Triglicéridos/análisis , Triglicéridos/metabolismo
17.
Gut ; 55(8): 1114-23, 2006 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-16469794

RESUMEN

BACKGROUND AND AIMS: The OCTN1 (SLC22A4 1672C-->T) and OCTN2 (SLC22A5 -207G-->C) variants within the IBD5 locus have been associated with susceptibility to adult onset Crohn's disease (CD), but their contribution in children has not been examined. METHODS: These OCTN1/2 variants and IBD5 marker single nucleotide polymorphisms (SNPs) (IGR2096a_1, IGR2198a_1, and IGR2230a_1) were examined in 299 Scottish children (200 with CD, 74 with ulcerative colitis (UC), and 25 with indeterminate colitis (IC)), together with 502 parents (for transmission disequilibrium testing) and 256 controls. RESULTS: All SNPs were in strong linkage disequilibrium (D' >0.94). TDT analysis showed association of the OCTN1 variant with inflammatory bowel disease (IBD) (p = 0.01) and CD (p = 0.04). Allele frequencies of the OCTN1/2 variants were significantly higher in IBD/CD cases (p<0.04). The homozygous mutant OCTN1/2 haplotype was increased in IBD (24.3% v 16.1%, p = 0.02) and UC (28.2% v 16.1%, p = 0.02) compared with controls. The OCTN1/2 variants were not independent of the background IBD5 risk haplotype in conferring disease susceptibility. Unifactorial analysis in CD patients showed that carriage of the TC haplotype was associated with lower weight, height, and BMI centile (<9(th) centile) at diagnosis (weight: 87.9% v 67.3% (p = 0.002), odds ratio (OR) = 3.52 (95% confidence interval, 1.51 to 8.22); height: 84.1% v 68.4% (p<0.05), OR = 2.44 (1.00 to 5.99); BMI: 79.6% v 61.1% (p = 0.02), OR = 2.49 (1.14 to 5.44)), and lower weight centile at follow up (87.5% v 64.6% (p = 0.03), OR = 3.83 (1.03 to 14.24)). Multifactorial binary logistic regression analysis confirmed association of the TC haplotype with lower weight centile at diagnosis (p = 0.02, OR = 3.41 (1.20 to 9.66)). CONCLUSIONS: These data implicate variants within the IBD5 haplotype, as determinants of disease susceptibility and growth indices in early onset IBD. The OCTN1/2 variants remain potential positional candidate genes, but require further analysis.


Asunto(s)
Predisposición Genética a la Enfermedad , Enfermedades Inflamatorias del Intestino/genética , Proteínas de Transporte de Catión Orgánico/genética , Adolescente , Adulto , Antropometría , Estudios de Casos y Controles , Niño , Colitis Ulcerosa/genética , Colitis Ulcerosa/patología , Colitis Ulcerosa/fisiopatología , Enfermedad de Crohn/genética , Enfermedad de Crohn/patología , Enfermedad de Crohn/fisiopatología , Epistasis Genética , Femenino , Genotipo , Crecimiento , Humanos , Hipersensibilidad Inmediata/complicaciones , Hipersensibilidad Inmediata/genética , Enfermedades Inflamatorias del Intestino/patología , Enfermedades Inflamatorias del Intestino/fisiopatología , Desequilibrio de Ligamiento , Masculino , Fenotipo , Polimorfismo de Nucleótido Simple , Miembro 5 de la Familia 22 de Transportadores de Solutos , Simportadores
18.
Eur J Clin Nutr ; 60(1): 69-76, 2006 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-16151459

RESUMEN

BACKGROUND: 13C-breath tests are noninvasive tools to measure gastrointestinal function and nutritional interventions. Calculation of percentage dose recovered of 13C in exhaled breath requires knowledge of CO2 production rate (VC02). A resting value is usually assumed, but this can underestimate VC02 because subjects are unlikely to remain at rest during tests that last for many hours. There is a need for a method to estimate nonresting VC02 during 13C-breath tests. OBJECTIVE: To calibrate a heart rate monitor to continually estimate VC02 during 13C-breath tests. DESIGN: Proof of concept study. SUBJECTS: Eight healthy adults, 10 healthy children and six children with cystic fibrosis. METHODS: Heart rate and VC02 were measured simultaneously at resting and nonresting levels. A new calibration method (smoothing heart rate and fitting a sigmoid function) was compared with published methods. A [ 3C]acetate breath test was used to demonstrate the range of physical activity during breath tests. RESULTS: The new calibration method was more accurate than existing methods (mean bias -0.0002%, 95% confidence interval (CI) -0.0007, 0.0003% of the mean measured VC02). Smoothing heart rate gave a more precise estimate of VC02 and a more accurate estimate of resting energy expenditure (mean bias -0.09, 95% Cl -0.22, 0.05 mmol CO2 min-' m-2 body surface area) than using raw data (mean bias -0.21, 95% Cl -0.38, -0.04 mmol CO2 min' m-2 body surface area). Physical activity level ranged from 1.0 to 2.5 in children, and 1.0 to 1.5 in adults. CONCLUSION: Use of smoothed HR with a sigmoid function provides an accurate method of estimating nonresting VC02 during 13C-breath tests.


Asunto(s)
Pruebas Respiratorias , Dióxido de Carbono/metabolismo , Fibrosis Quística/metabolismo , Ejercicio Físico/fisiología , Frecuencia Cardíaca/fisiología , Adolescente , Adulto , Metabolismo Basal/fisiología , Calibración , Dióxido de Carbono/análisis , Isótopos de Carbono , Niño , Preescolar , Fibrosis Quística/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Consumo de Oxígeno/fisiología , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
20.
Arch Dis Child Fetal Neonatal Ed ; 90(2): F103-8, 2005 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15724031

RESUMEN

Vitamin A is essential for optimal growth and development. In the developing world, vitamin A supplementation of the newborn infant reduces mortality. In the developed world, extremely preterm infants are born with low body stores of vitamin A and are at high risk of vitamin A deficiency. Optimal vitamin A supplementation for this population is not clearly defined, however, and, despite evidence of benefit, early vitamin A supplementation of extremely preterm infants is not uniformly practised in the United Kingdom. There is an urgent need for studies in preterm infants that include quantification of hepatic stores and functional assessment of vitamin A status as well as long term outcome.


Asunto(s)
Enfermedades del Prematuro/metabolismo , Deficiencia de Vitamina A/metabolismo , Vitamina A/metabolismo , Suplementos Dietéticos , Ojo/metabolismo , Humanos , Recién Nacido , Enfermedades del Prematuro/dietoterapia , Recién Nacido de muy Bajo Peso/metabolismo , Hígado/metabolismo , Pulmón/metabolismo , Respiración , Retinopatía de la Prematuridad/etiología , Visión Ocular/fisiología , Vitamina A/administración & dosificación , Vitamina A/farmacocinética , Deficiencia de Vitamina A/dietoterapia
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...