RESUMO
OBJECTIVES: To measure resting energy expenditure (REE) and determine whether increased REE (hypermetabolism) is associated with failure to thrive (FTT) in patients with severe combined immunodeficiency (SCID) at diagnosis. STUDY DESIGN: REE was measured in 26 patients with SCID in a single transplant center. Predicted REE was determined with World Health Organization standards. Measured REE >110% of predicted REE was classified as hypermetabolism. Other data collected included FTT status, infections, genotype, phenotype, and the feeding methods used. RESULTS: Fifteen of 26 patients (57.7%) had FTT, and 18 of 26 patients (69.2%) were hypermetabolic. Hypermetabolism occured in 14 of 15 patients (93%) with FTT, and only 4 of 11 patients (36%) without FTT had hypermetabolism (P = .003). There was a significant difference between the measured REE (71.75 ± 16.6 kcal/kg) and the predicted REE (52.85 ± 2.8 kcal/kg; P < .0001). Eleven of 17 patients (65%) required nasogastric feeding, parenteral nutrition, or both to meet their energy needs. CONCLUSIONS: Hypermetabolism is common in patients with SCID and may contribute to the development of FTT. The hypermetabolism in these patients may necessitate intensive nutrition support.
Assuntos
Metabolismo Energético/fisiologia , Insuficiência de Crescimento/fisiopatologia , Descanso/fisiologia , Imunodeficiência Combinada Severa/fisiopatologia , Calorimetria Indireta , Diarreia/epidemiologia , Insuficiência de Crescimento/terapia , Fezes/virologia , Humanos , Lactente , Fórmulas Infantis , Recém-Nascido , Infecções/epidemiologia , Intubação Gastrointestinal , Modelos Logísticos , Mutação , Nutrição Parenteral , Pneumonia/epidemiologia , Receptores de Interleucina-2/genética , Estudos RetrospectivosRESUMO
OBJECTIVE: To assess how often the patients in The Hospital for Sick Children's rheumatology clinic use complementary and alternative medicine (CAM), and the type of CAM used. METHODS: Cross-sectional descriptive survey study in a tertiary care referral center. RESULTS: We found that 90 (64%) of 141 respondents used at least 1 form of CAM; 45 (50%) of these 90 used more than 1 form. Duration of illness was positively associated with the use of CAM; the difference in the mean length of illness between users (4.12 +/- 3.60 years) and nonusers (2.82 +/- 3.23 years) was 1.3 years (P = 0.04). Of the 41 respondents with more than 1 illness, 32 used CAM, compared with 57 of 96 who had only 1 illness (P = 0.036). CONCLUSION: Health care providers must be aware of their patients' possible use of CAM, especially those with more than 1 illness.